- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,439.06 / $1,439.06 / $9,768.00
| Facility | | $1,439.06 | $1,439.06 | $9,768.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,935.79 / $11,098.97 / $21,650.55
| Facility | | $5,935.79 | $11,098.97 | $21,650.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,333.68 / $4,727.57 / $11,372.82
| Facility | | $3,333.68 | $4,727.57 | $11,372.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,710.04 / $4,322.14 / $8,954.98
| Facility | | $2,710.04 | $4,322.14 | $8,954.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,694.35 / $2,747.40 / $10,533.00
| Facility | | $1,694.35 | $2,747.40 | $10,533.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,940.00 / $8,689.00 / $11,531.00
| Facility | | $3,940.00 | $8,689.00 | $11,531.00 |