- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,031.07 / $1,031.07 / $6,542.00
| Facility | | $1,031.07 | $1,031.07 | $6,542.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,546.10 / $11,907.67 / $24,323.22
| Facility | | $4,546.10 | $11,907.67 | $24,323.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,388.66 / $3,387.42 / $8,148.89
| Facility | | $2,388.66 | $3,387.42 | $8,148.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,941.81 / $3,096.91 / $6,416.45
| Facility | | $1,941.81 | $3,096.91 | $6,416.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,330.04 / $1,972.13 / $9,255.00
| Facility | | $1,330.04 | $1,972.13 | $9,255.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,293.00 / $6,652.00 / $9,810.00
| Facility | | $3,293.00 | $6,652.00 | $9,810.00 |