- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,757.00 / $6,071.00 / $13,151.00
| Facility | | $2,757.00 | $6,071.00 | $13,151.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,411.10 / $3,551.35 / $5,952.49
| Facility | | $2,411.10 | $3,551.35 | $5,952.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $624.00 / $624.00 / $624.00
| Facility | | $624.00 | $624.00 | $624.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $650.12 / $1,015.14 / $6,988.00
| Facility | | $650.12 | $1,015.14 | $6,988.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,833.00 / $3,946.00 / $8,348.00
| Facility | | $1,833.00 | $3,946.00 | $8,348.00 |