- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,010.30 / $1,290.38 / $9,311.00
| Facility | | $1,010.30 | $1,290.38 | $9,311.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,049.25 / $9,122.94 / $15,243.15
| Facility | | $5,049.25 | $9,122.94 | $15,243.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $990.64 / $1,359.69 / $1,568.51
| Facility | | $990.64 | $1,359.69 | $1,568.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,192.73 / $1,192.73 / $1,192.73
| Facility | | $1,192.73 | $1,192.73 | $1,192.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $631.00 / $1,121.00 / $8,582.00
| Facility | | $631.00 | $1,121.00 | $8,582.00 |