- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,366.81 / $1,366.81 / $8,957.00
| Facility | | $1,366.81 | $1,366.81 | $8,957.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,060.42 / $10,832.70 / $21,521.97
| Facility | | $6,060.42 | $10,832.70 | $21,521.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,014.46 / $4,274.88 / $10,283.81
| Facility | | $3,014.46 | $4,274.88 | $10,283.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,450.54 / $3,908.27 / $8,097.49
| Facility | | $2,450.54 | $3,908.27 | $8,097.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,910.69 / $2,493.16 / $3,710.75
| Facility | | $1,910.69 | $2,493.16 | $3,710.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,445.00 / $3,236.00 / $5,530.00
| Facility | | $1,445.00 | $3,236.00 | $5,530.00 |