- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,128.32 / $1,313.98 / $4,828.00
| Facility | | $1,128.32 | $1,313.98 | $4,828.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,291.50 / $10,745.13 / $21,650.55
| Facility | | $5,291.50 | $10,745.13 | $21,650.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,181.28 / $4,513.77 / $10,858.48
| Facility | | $3,181.28 | $4,513.77 | $10,858.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,892.07 / $4,126.67 / $8,549.99
| Facility | | $2,892.07 | $4,126.67 | $8,549.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,229.59 / $2,064.54 / $3,546.70
| Facility | | $1,229.59 | $2,064.54 | $3,546.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,940.00 / $7,872.00 / $11,531.00
| Facility | | $3,940.00 | $7,872.00 | $11,531.00 |