- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,653.00 / $5,463.36 / $13,841.56
| Facility | | $1,653.00 | $5,463.36 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $898.23 / $1,181.41 / $2,285.23
| Facility | | $898.23 | $1,181.41 | $2,285.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $249.82 / $557.61 / $1,775.00
| Facility | | $249.82 | $557.61 | $1,775.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.54 / $761.93 / $1,120.53
| Facility | | $537.54 | $761.93 | $1,120.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,031.00 / $1,775.00 / $4,406.00
| Facility | | $1,031.00 | $1,775.00 | $4,406.00 |