- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,273.14 / $1,273.14 / $7,397.00
| Facility | | $1,273.14 | $1,273.14 | $7,397.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,578.25 / $10,656.64 / $21,650.55
| Facility | | $5,578.25 | $10,656.64 | $21,650.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,152.59 / $4,470.77 / $10,755.04
| Facility | | $3,152.59 | $4,470.77 | $10,755.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,562.83 / $4,087.36 / $8,468.54
| Facility | | $2,562.83 | $4,087.36 | $8,468.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,609.17 / $2,572.19 / $10,533.00
| Facility | | $1,609.17 | $2,572.19 | $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 |