- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,262.33 / $8,783.00 / $16,639.00
| Facility | | $1,262.33 | $8,783.00 | $16,639.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,054.52 / $3,883.00 / $6,494.50
| Facility | | $2,054.52 | $3,883.00 | $6,494.50 |
- 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
- $1,085.16 / $1,300.00 / $1,977.64
| Facility | | $1,085.16 | $1,300.00 | $1,977.64 |
- 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 |