- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,535.00 / $5,467.00 / $12,237.00
| Facility | | $1,535.00 | $5,467.00 | $12,237.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,339.50 / $1,975.66 / $3,130.84
| Facility | | $1,339.50 | $1,975.66 | $3,130.84 |
- 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
- $851.14 / $1,332.47 / $6,239.00
| Facility | | $851.14 | $1,332.47 | $6,239.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,779.00 / $3,946.00 / $6,988.00
| Facility | | $1,779.00 | $3,946.00 | $6,988.00 |