- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,066.34 / $1,066.34 / $6,575.00
| Facility | | $1,066.34 | $1,066.34 | $6,575.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,153.64 / $10,745.13 / $21,650.55
| Facility | | $5,153.64 | $10,745.13 | $21,650.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,565.90 / $3,640.64 / $8,758.04
| Facility | | $2,565.90 | $3,640.64 | $8,758.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.63 / $3,328.42 / $6,896.10
| Facility | | $2,332.63 | $3,328.42 | $6,896.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,108.88 / $1,848.15 / $5,331.00
| Facility | | $1,108.88 | $1,848.15 | $5,331.00 |
- 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 |