- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,015.39 / $1,015.39 / $7,436.13
| Facility | | $1,015.39 | $1,015.39 | $7,436.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,118.87 / $7,705.83 / $15,031.63
| Facility | | $4,118.87 | $7,705.83 | $15,031.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,362.17 / $3,351.58 / $8,062.69
| Facility | | $2,362.17 | $3,351.58 | $8,062.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,921.27 / $3,064.15 / $6,348.58
| Facility | | $1,921.27 | $3,064.15 | $6,348.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,125.47 / $1,812.90 / $10,298.70
| Facility | | $1,125.47 | $1,812.90 | $10,298.70 |
- 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 |