- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,388.65 / $1,388.65 / $4,828.00
| Facility | | $1,388.65 | $1,388.65 | $4,828.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,677.15 / $7,489.63 / $12,490.46
| Facility | | $3,677.15 | $7,489.63 | $12,490.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,371.53 / $4,783.71 / $11,507.87
| Facility | | $3,371.53 | $4,783.71 | $11,507.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,065.03 / $4,373.46 / $9,061.31
| Facility | | $3,065.03 | $4,373.46 | $9,061.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,447.72 / $2,619.80 / $4,746.00
| Facility | | $1,447.72 | $2,619.80 | $4,746.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,412.00 / $4,746.00 / $8,812.00
| Facility | | $2,412.00 | $4,746.00 | $8,812.00 |