- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,196.52 / $1,196.52 / $8,666.00
| Facility | | $1,196.52 | $1,196.52 | $8,666.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,908.66 / $17,550.78 / $36,581.76
| Facility | | $5,908.66 | $17,550.78 | $36,581.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,027.10 / $4,292.80 / $10,326.91
| Facility | | $3,027.10 | $4,292.80 | $10,326.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,460.81 / $3,924.65 / $8,131.43
| Facility | | $2,460.81 | $3,924.65 | $8,131.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,703.43 / $2,525.78 / $12,051.00
| Facility | | $1,703.43 | $2,525.78 | $12,051.00 |
- 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 |