- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,285.50 / $14,364.10 / $19,871.00
| Facility | | $4,285.50 | $14,364.10 | $19,871.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $2,703.05 / $4,166.18
| Facility | | $1,146.00 | $2,703.05 | $4,166.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,406.44 / $7,470.06 / $13,855.88
| Facility | | $5,406.44 | $7,470.06 | $13,855.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,406.44 / $7,470.06 / $13,855.88
| Facility | | $5,406.44 | $7,470.06 | $13,855.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,028.37 / $9,560.95 / $14,824.40
| Facility | | $4,028.37 | $9,560.95 | $14,824.40 |