- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,025.55 / $3,884.00 / $9,392.95
| Facility | | $1,025.55 | $3,884.00 | $9,392.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,041.23 / $6,069.38 / $8,064.81
| Facility | | $3,041.23 | $6,069.38 | $8,064.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $505.00 / $505.00 / $505.00
| Facility | | $505.00 | $505.00 | $505.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $655.21 / $1,031.54 / $11,642.00
| Facility | | $655.21 | $1,031.54 | $11,642.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,269.00 / $6,407.00 / $12,989.00
| Facility | | $2,269.00 | $6,407.00 | $12,989.00 |