- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,144.61 / $1,836.21 / $15,291.00
| Facility | | $1,144.61 | $1,836.21 | $15,291.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,790.43 / $5,790.43 / $5,874.92
| Facility | | $5,790.43 | $5,790.43 | $5,874.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,182.48 / $1,182.48 / $25,104.40
| Facility | | $1,182.48 | $1,182.48 | $25,104.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,144.61 / $1,445.88 / $2,376.82
| Facility | | $1,144.61 | $1,445.88 | $2,376.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,153.00 / $21,463.00 / $29,047.00
| Facility | | $8,153.00 | $21,463.00 | $29,047.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,675.99 / $72,415.14 / $82,965.55
| Facility | | $7,675.99 | $72,415.14 | $82,965.55 |