- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,393.02 / $4,389.32 / $12,247.00
| Facility | | $1,393.02 | $4,389.32 | $12,247.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,182.48 / $3,394.57 / $5,654.79
| Facility | | $1,182.48 | $3,394.57 | $5,654.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,151.00 / $1,640.39 / $2,536.09
| Facility | | $1,151.00 | $1,640.39 | $2,536.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,461.00 / $2,050.00 / $15,712.00
| Facility | | $1,461.00 | $2,050.00 | $15,712.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,385.84 / $16,547.20 / $26,542.00
| Facility | | $10,385.84 | $16,547.20 | $26,542.00 |