- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,036.33 / $1,801.31 / $10,561.00
| Facility | | $1,036.33 | $1,801.31 | $10,561.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,474.86 / $3,474.86 / $3,525.56
| Facility | | $3,474.86 | $3,474.86 | $3,525.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $748.70 / $748.70 / $6,640.38
| Facility | | $748.70 | $748.70 | $6,640.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $840.00 / $1,801.31 / $3,036.49
| Facility | | $840.00 | $1,801.31 | $3,036.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,183.00 / $12,216.00 / $19,066.00
| Facility | | $3,183.00 | $12,216.00 | $19,066.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,136.34 / $7,136.34 / $26,542.00
| Facility | | $7,136.34 | $7,136.34 | $26,542.00 |