- 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
- $598.00 / $1,332.33 / $1,402.45
| Facility | | $598.00 | $1,332.33 | $1,402.45 |
- 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
- $735.43 / $1,118.04 / $3,810.00
| Facility | | $735.43 | $1,118.04 | $3,810.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,031.00 / $2,441.82 / $3,331.00
| Facility | | $1,031.00 | $2,441.82 | $3,331.00 |