- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,053.38 / $1,053.38 / $7,494.00
| Facility | | $1,053.38 | $1,053.38 | $7,494.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,724.01 / $9,984.76 / $21,650.55
| Facility | | $4,724.01 | $9,984.76 | $21,650.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,571.42 / $3,646.61 / $8,772.41
| Facility | | $2,571.42 | $3,646.61 | $8,772.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,090.39 / $3,333.88 / $6,907.41
| Facility | | $2,090.39 | $3,333.88 | $6,907.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,438.47 / $2,132.91 / $10,493.00
| Facility | | $1,438.47 | $2,132.91 | $10,493.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,940.00 / $8,689.00 / $11,531.00
| Facility | | $3,940.00 | $8,689.00 | $11,531.00 |