- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,162.61 / $1,162.61 / $6,283.00
| Facility | | $1,162.61 | $1,162.61 | $6,283.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,360.43 / $10,069.45 / $21,131.14
| Facility | | $5,360.43 | $10,069.45 | $21,131.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,551.21 / $3,617.94 / $8,703.45
| Facility | | $2,551.21 | $3,617.94 | $8,703.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,073.96 / $3,307.67 / $6,853.11
| Facility | | $2,073.96 | $3,307.67 | $6,853.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,751.00 / $2,120.94 / $3,500.00
| Facility | | $1,751.00 | $2,120.94 | $3,500.00 |
- 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 |