- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,315.19 / $8,783.00 / $16,467.00
| Facility | | $1,315.19 | $8,783.00 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,373.28 / $5,120.34 / $8,981.33
| Facility | | $2,373.28 | $5,120.34 | $8,981.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $580.00 / $580.00 / $1,604.11
| Facility | | $580.00 | $580.00 | $1,604.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,138.19 / $1,496.00 / $2,024.00
| Facility | | $1,138.19 | $1,496.00 | $2,024.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $659.00 / $6,607.00 / $8,667.00
| Facility | | $659.00 | $6,607.00 | $8,667.00 |