- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,216.46 / $1,216.46 / $10,647.00
| Facility | | $1,216.46 | $1,216.46 | $10,647.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,511.39 / $7,775.25 / $16,508.77
| Facility | | $4,511.39 | $7,775.25 | $16,508.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,250.30 / $4,609.32 / $11,088.35
| Facility | | $3,250.30 | $4,609.32 | $11,088.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,642.26 / $4,214.03 / $8,730.99
| Facility | | $2,642.26 | $4,214.03 | $8,730.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,033.89 / $2,376.25 / $4,022.14
| Facility | | $2,033.89 | $2,376.25 | $4,022.14 |
- 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 |