- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,559.60 / $6,187.17 / $11,674.00
| Facility | | $1,559.60 | $6,187.17 | $11,674.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,730.51 / $3,922.28 / $8,371.94
| Facility | | $1,730.51 | $3,922.28 | $8,371.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $377.94 / $580.00 / $1,370.63
| Facility | | $377.94 | $580.00 | $1,370.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $350.36 / $457.44 / $702.33
| Facility | | $350.36 | $457.44 | $702.33 |
- 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 |