- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,108.67 / $1,108.67 / $7,494.00
| Facility | | $1,108.67 | $1,108.67 | $7,494.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,641.42 / $9,984.76 / $21,650.55
| Facility | | $4,641.42 | $9,984.76 | $21,650.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,579.01 / $3,657.36 / $8,798.27
| Facility | | $2,579.01 | $3,657.36 | $8,798.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,096.55 / $3,343.70 / $6,927.78
| Facility | | $2,096.55 | $3,343.70 | $6,927.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,441.20 / $2,136.94 / $7,770.00
| Facility | | $1,441.20 | $2,136.94 | $7,770.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,735.00 / $4,974.00 / $8,812.00
| Facility | | $2,735.00 | $4,974.00 | $8,812.00 |