- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,187.31 / $1,187.31 / $9,419.00
| Facility | | $1,187.31 | $1,187.31 | $9,419.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,748.94 / $11,203.41 / $22,223.37
| Facility | | $6,748.94 | $11,203.41 | $22,223.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,621.97 / $3,718.28 / $8,944.82
| Facility | | $2,621.97 | $3,718.28 | $8,944.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,131.46 / $3,399.40 / $7,043.16
| Facility | | $2,131.46 | $3,399.40 | $7,043.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,797.31 / $2,491.87 / $12,367.00
| Facility | | $1,797.31 | $2,491.87 | $12,367.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,577.00 / $10,743.00 / $12,774.00
| Facility | | $5,577.00 | $10,743.00 | $12,774.00 |