- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,123.57 / $1,123.57 / $7,859.00
| Facility | | $1,123.57 | $1,123.57 | $7,859.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,496.15 / $10,586.97 / $21,331.89
| Facility | | $5,496.15 | $10,586.97 | $21,331.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,607.38 / $4,069.44 / $9,789.59
| Facility | | $2,607.38 | $4,069.44 | $9,789.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,259.52 / $3,713.63 / $7,708.34
| Facility | | $2,259.52 | $3,713.63 | $7,708.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,196.47 / $2,008.66 / $3,509.71
| Facility | | $1,196.47 | $2,008.66 | $3,509.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $796.00 / $2,260.00 / $5,379.86
| Facility | | $796.00 | $2,260.00 | $5,379.86 |