- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,328.28 / $1,328.28 / $7,397.00
| Facility | | $1,328.28 | $1,328.28 | $7,397.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,718.06 / $11,098.97 / $21,650.55
| Facility | | $5,718.06 | $11,098.97 | $21,650.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,294.94 / $4,672.63 / $11,240.64
| Facility | | $3,294.94 | $4,672.63 | $11,240.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,678.55 / $4,271.89 / $8,850.90
| Facility | | $2,678.55 | $4,271.89 | $8,850.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,776.81 / $2,700.29 / $10,878.00
| Facility | | $1,776.81 | $2,700.29 | $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 |