- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,340.89 / $8,783.00 / $16,639.00
| Facility | | $1,340.89 | $8,783.00 | $16,639.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,294.50 / $7,206.40 / $12,212.57
| Facility | | $3,294.50 | $7,206.40 | $12,212.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,319.93 / $2,345.00 / $24,288.08
| Facility | | $1,319.93 | $2,345.00 | $24,288.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,246.86 / $1,389.13 / $2,630.12
| Facility | | $1,246.86 | $1,389.13 | $2,630.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,155.00 / $12,456.00 / $19,591.00
| Facility | | $2,155.00 | $12,456.00 | $19,591.00 |