- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,186.63 / $1,186.63 / $8,302.00
| Facility | | $1,186.63 | $1,186.63 | $8,302.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,833.62 / $8,289.08 / $15,949.15
| Facility | | $4,833.62 | $8,289.08 | $15,949.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,758.68 / $3,914.16 / $9,416.04
| Facility | | $2,758.68 | $3,914.16 | $9,416.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,243.76 / $3,578.48 / $7,414.21
| Facility | | $2,243.76 | $3,578.48 | $7,414.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,271.10 / $2,118.52 / $10,421.57
| Facility | | $1,271.10 | $2,118.52 | $10,421.57 |
- 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 |