- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,368.36 / $1,368.36 / $10,647.00
| Facility | | $1,368.36 | $1,368.36 | $10,647.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,088.66 / $22,802.40 / $44,489.13
| Facility | | $13,088.66 | $22,802.40 | $44,489.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,095.32 / $4,389.55 / $10,559.65
| Facility | | $3,095.32 | $4,389.55 | $10,559.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,516.27 / $4,013.10 / $8,314.69
| Facility | | $2,516.27 | $4,013.10 | $8,314.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,958.09 / $2,811.88 / $12,367.00
| Facility | | $1,958.09 | $2,811.88 | $12,367.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,577.00 / $10,743.00 / $12,774.00
| Facility | | $5,577.00 | $10,743.00 | $12,774.00 |