- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,380.15 / $1,380.15 / $4,828.00
| Facility | | $1,380.15 | $1,380.15 | $4,828.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,527.12 / $3,895.97 / $11,329.24
| Facility | | $1,527.12 | $3,895.97 | $11,329.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,218.09 / $5,022.60 / $12,082.54
| Facility | | $3,218.09 | $5,022.60 | $12,082.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,788.76 / $4,583.45 / $9,513.81
| Facility | | $2,788.76 | $4,583.45 | $9,513.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,429.85 / $2,501.96 / $4,311.21
| Facility | | $1,429.85 | $2,501.96 | $4,311.21 |
- 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 |