- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,067.04 / $1,067.04 / $7,191.00
| Facility | | $1,067.04 | $1,067.04 | $7,191.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,752.89 / $10,188.53 / $21,650.55
| Facility | | $4,752.89 | $10,188.53 | $21,650.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,642.18 / $3,746.94 / $9,013.78
| Facility | | $2,642.18 | $3,746.94 | $9,013.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,147.90 / $3,425.60 / $7,097.46
| Facility | | $2,147.90 | $3,425.60 | $7,097.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,382.15 / $2,175.52 / $10,533.00
| Facility | | $1,382.15 | $2,175.52 | $10,533.00 |
- 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 |