- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,402.69 / $1,402.69 / $10,647.00
| Facility | | $1,402.69 | $1,402.69 | $10,647.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,904.12 / $17,908.96 / $36,581.76
| Facility | | $6,904.12 | $17,908.96 | $36,581.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,557.72 / $5,045.29 / $12,137.14
| Facility | | $3,557.72 | $5,045.29 | $12,137.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,892.17 / $4,612.60 / $9,556.79
| Facility | | $2,892.17 | $4,612.60 | $9,556.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,994.87 / $2,958.49 / $25,103.03
| Facility | | $1,994.87 | $2,958.49 | $25,103.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,577.00 / $10,743.00 / $12,774.00
| Facility | | $5,577.00 | $10,743.00 | $12,774.00 |