- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,323.56 / $1,323.56 / $10,506.00
| Facility | | $1,323.56 | $1,323.56 | $10,506.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,428.23 / $15,768.49 / $33,458.26
| Facility | | $7,428.23 | $15,768.49 | $33,458.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,002.67 / $4,258.16 / $10,243.58
| Facility | | $3,002.67 | $4,258.16 | $10,243.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,440.96 / $3,892.98 / $8,065.81
| Facility | | $2,440.96 | $3,892.98 | $8,065.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,885.29 / $2,729.28 / $12,367.00
| Facility | | $1,885.29 | $2,729.28 | $12,367.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,658.00 / $8,582.00 / $12,722.00
| Facility | | $5,658.00 | $8,582.00 | $12,722.00 |