- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,327.29 / $1,327.29 / $7,397.00
| Facility | | $1,327.29 | $1,327.29 | $7,397.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,327.72 / $11,032.28 / $22,633.97
| Facility | | $6,327.72 | $11,032.28 | $22,633.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,096.40 / $4,832.68 / $11,625.68
| Facility | | $3,096.40 | $4,832.68 | $11,625.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,683.31 / $4,410.14 / $9,154.08
| Facility | | $2,683.31 | $4,410.14 | $9,154.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,367.94 / $2,247.16 / $4,158.50
| Facility | | $1,367.94 | $2,247.16 | $4,158.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $796.00 / $3,500.00 / $8,152.00
| Facility | | $796.00 | $3,500.00 | $8,152.00 |