- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.66 / $1,047.66 / $6,781.00
| Facility | | $1,047.66 | $1,047.66 | $6,781.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,762.51 / $10,188.53 / $21,650.55
| Facility | | $4,762.51 | $10,188.53 | $21,650.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,602.60 / $3,690.80 / $8,878.73
| Facility | | $2,602.60 | $3,690.80 | $8,878.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,115.71 / $3,374.28 / $6,991.13
| Facility | | $2,115.71 | $3,374.28 | $6,991.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,347.71 / $2,131.79 / $10,878.00
| Facility | | $1,347.71 | $2,131.79 | $10,878.00 |
- 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 |