- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,188.33 / $9,062.00 / $18,276.00
| Facility | | $1,188.33 | $9,062.00 | $18,276.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,237.07 / $4,803.12 / $8,557.95
| Facility | | $2,237.07 | $4,803.12 | $8,557.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,100.00 / $1,181.70 / $1,965.14
| Facility | | $1,100.00 | $1,181.70 | $1,965.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,095.00 / $1,398.00 / $2,282.38
| Facility | | $1,095.00 | $1,398.00 | $2,282.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $729.00 / $6,607.00 / $8,667.00
| Facility | | $729.00 | $6,607.00 | $8,667.00 |