- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,037.13 / $11,269.00 / $16,467.00
| Facility | | $1,037.13 | $11,269.00 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,873.77 / $7,263.19 / $12,492.30
| Facility | | $3,873.77 | $7,263.19 | $12,492.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $890.00 / $890.00 / $1,028.58
| Facility | | $890.00 | $890.00 | $1,028.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,008.19 / $1,274.00 / $2,004.06
| Facility | | $1,008.19 | $1,274.00 | $2,004.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,327.00 / $12,269.00 / $19,591.00
| Facility | | $2,327.00 | $12,269.00 | $19,591.00 |