- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,233.09 / $1,233.09 / $8,053.00
| Facility | | $1,233.09 | $1,233.09 | $8,053.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,444.42 / $10,616.05 / $22,420.97
| Facility | | $5,444.42 | $10,616.05 | $22,420.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,718.83 / $3,855.64 / $9,275.25
| Facility | | $2,718.83 | $3,855.64 | $9,275.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,210.21 / $3,524.98 / $7,303.35
| Facility | | $2,210.21 | $3,524.98 | $7,303.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,751.00 / $2,254.40 / $3,500.00
| Facility | | $1,751.00 | $2,254.40 | $3,500.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,751.00 / $3,500.00 / $8,152.00
| Facility | | $1,751.00 | $3,500.00 | $8,152.00 |