- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,101.97 / $9,062.00 / $18,276.00
| Facility | | $1,101.97 | $9,062.00 | $18,276.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,709.21 / $5,405.49 / $8,981.33
| Facility | | $2,709.21 | $5,405.49 | $8,981.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $715.00 / $715.00 / $3,200.28
| Facility | | $715.00 | $715.00 | $3,200.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $947.31 / $1,175.54 / $1,716.51
| Facility | | $947.31 | $1,175.54 | $1,716.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,155.00 / $12,798.00 / $19,665.00
| Facility | | $2,155.00 | $12,798.00 | $19,665.00 |