- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,127.19 / $1,127.19 / $11,009.00
| Facility | | $1,127.19 | $1,127.19 | $11,009.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,085.60 / $27,584.05 / $62,316.23
| Facility | | $5,085.60 | $27,584.05 | $62,316.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,546.16 / $3,610.78 / $8,686.20
| Facility | | $2,546.16 | $3,610.78 | $8,686.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,069.85 / $3,301.12 / $6,839.54
| Facility | | $2,069.85 | $3,301.12 | $6,839.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,776.08 / $2,354.30 / $46,518.43
| Facility | | $1,776.08 | $2,354.30 | $46,518.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,891.00 / $13,757.00 / $32,027.00
| Facility | | $5,891.00 | $13,757.00 | $32,027.00 |