- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,003.70 / $4,387.00 / $10,439.00
| Facility | | $1,003.70 | $4,387.00 | $10,439.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $514.00 / $1,332.33 / $1,402.45
| Facility | | $514.00 | $1,332.33 | $1,402.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $442.00 / $442.00 / $442.00
| Facility | | $442.00 | $442.00 | $442.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $672.77 / $1,025.08 / $3,810.00
| Facility | | $672.77 | $1,025.08 | $3,810.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $825.00 / $2,081.00 / $3,918.00
| Facility | | $825.00 | $2,081.00 | $3,918.00 |