- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,332.00 / $3,116.40 / $16,467.00
| Facility | | $1,332.00 | $3,116.40 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,441.81 / $5,364.75 / $9,222.64
| Facility | | $2,441.81 | $5,364.75 | $9,222.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,324.34 / $1,965.14 / $2,345.00
| Facility | | $1,324.34 | $1,965.14 | $2,345.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,192.51 / $1,429.88 / $2,568.35
| Facility | | $1,192.51 | $1,429.88 | $2,568.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,550.00 / $10,257.00 / $16,249.00
| Facility | | $1,550.00 | $10,257.00 | $16,249.00 |