- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,322.42 / $7,660.09 / $16,467.00
| Facility | | $4,322.42 | $7,660.09 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,051.15 / $6,367.43 / $11,552.91
| Facility | | $3,051.15 | $6,367.43 | $11,552.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616.38 / $2,000.00 / $2,581.96
| Facility | | $616.38 | $2,000.00 | $2,581.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $584.79 / $720.00 / $1,154.53
| Facility | | $584.79 | $720.00 | $1,154.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,155.00 / $12,456.00 / $19,591.00
| Facility | | $2,155.00 | $12,456.00 | $19,591.00 |