- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,392.00 / $4,856.00 / $14,100.00
| Facility | | $1,392.00 | $4,856.00 | $14,100.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,175.22 / $6,632.94 / $10,479.96
| Facility | | $4,175.22 | $6,632.94 | $10,479.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,248.01 / $2,248.01 / $2,248.01
| Facility | | $2,248.01 | $2,248.01 | $2,248.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $599.39 / $817.35 / $8,110.49
| Facility | | $599.39 | $817.35 | $8,110.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,481.00 / $5,910.00 / $9,232.95
| Facility | | $1,481.00 | $5,910.00 | $9,232.95 |