- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,005.00 / $10,431.19 / $20,928.72
| Facility | | $5,005.00 | $10,431.19 | $20,928.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,889.38 / $7,684.16 / $14,983.55
| Facility | | $5,889.38 | $7,684.16 | $14,983.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,821.47 / $1,821.47 / $1,821.47
| Facility | | $1,821.47 | $1,821.47 | $1,821.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,112.57 / $2,576.52 / $7,934.00
| Facility | | $1,112.57 | $2,576.52 | $7,934.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,409.14 / $2,308.21 / $3,155.00
| Facility | | $1,409.14 | $2,308.21 | $3,155.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,217.00 / $6,451.00 / $7,934.00
| Facility | | $4,217.00 | $6,451.00 | $7,934.00 |