- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,072.49 / $2,763.46 / $16,467.00
| Facility | | $1,072.49 | $2,763.46 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,001.95 / $5,057.09 / $8,656.54
| Facility | | $2,001.95 | $5,057.09 | $8,656.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $580.00 / $890.00 / $1,453.97
| Facility | | $580.00 | $890.00 | $1,453.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $932.24 / $1,221.00 / $2,095.11
| Facility | | $932.24 | $1,221.00 | $2,095.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,550.00 / $10,257.00 / $16,249.00
| Facility | | $1,550.00 | $10,257.00 | $16,249.00 |