- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,788.47 / $1,788.47 / $6,283.00
| Facility | | $1,788.47 | $1,788.47 | $6,283.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,428.23 / $12,076.23 / $23,114.40
| Facility | | $7,428.23 | $12,076.23 | $23,114.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,956.96 / $5,611.46 / $13,499.12
| Facility | | $3,956.96 | $5,611.46 | $13,499.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,216.72 / $5,130.22 / $10,629.23
| Facility | | $3,216.72 | $5,130.22 | $10,629.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,211.98 / $3,279.83 / $4,881.60
| Facility | | $2,211.98 | $3,279.83 | $4,881.60 |
- 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 |