- 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
- $984.20 / $1,450.76 / $3,055.34
| Facility | | $984.20 | $1,450.76 | $3,055.34 |
- 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
- $670.67 / $1,044.29 / $6,988.00
| Facility | | $670.67 | $1,044.29 | $6,988.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,900.00 / $5,043.00 / $6,239.00
| Facility | | $1,900.00 | $5,043.00 | $6,239.00 |