- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $977.42 / $977.42 / $7,981.00
| Facility | | $977.42 | $977.42 | $7,981.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,378.37 / $7,107.25 / $13,873.86
| Facility | | $4,378.37 | $7,107.25 | $13,873.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,482.98 / $3,521.19 / $8,470.70
| Facility | | $2,482.98 | $3,521.19 | $8,470.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,018.50 / $3,219.22 / $6,669.85
| Facility | | $2,018.50 | $3,219.22 | $6,669.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,376.22 / $1,777.91 / $3,378.00
| Facility | | $1,376.22 | $1,777.91 | $3,378.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,751.00 / $3,500.00 / $8,152.00
| Facility | | $1,751.00 | $3,500.00 | $8,152.00 |