- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,022.29 / $1,022.29 / $7,397.00
| Facility | | $1,022.29 | $1,022.29 | $7,397.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,812.21 / $10,745.13 / $21,650.55
| Facility | | $4,812.21 | $10,745.13 | $21,650.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,468.25 / $3,502.08 / $8,424.74
| Facility | | $2,468.25 | $3,502.08 | $8,424.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,243.86 / $3,201.74 / $6,633.65
| Facility | | $2,243.86 | $3,201.74 | $6,633.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,044.69 / $1,756.98 / $5,331.00
| Facility | | $1,044.69 | $1,756.98 | $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 |