- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,048.16 / $1,048.16 / $7,397.00
| Facility | | $1,048.16 | $1,048.16 | $7,397.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,297.38 / $24,536.18 / $48,429.15
| Facility | | $14,297.38 | $24,536.18 | $48,429.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,575.64 / $3,652.58 / $8,786.78
| Facility | | $2,575.64 | $3,652.58 | $8,786.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,093.81 / $3,339.34 / $6,918.73
| Facility | | $2,093.81 | $3,339.34 | $6,918.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,471.16 / $2,142.60 / $11,496.00
| Facility | | $1,471.16 | $2,142.60 | $11,496.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,028.00 / $11,496.00 / $21,528.00
| Facility | | $5,028.00 | $11,496.00 | $21,528.00 |