- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,757.00 / $5,939.00 / $13,151.00
| Facility | | $2,757.00 | $5,939.00 | $13,151.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,112.00 / $4,532.57 / $6,500.36
| Facility | | $2,112.00 | $4,532.57 | $6,500.36 |
- 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
- $483.73 / $835.27 / $3,647.00
| Facility | | $483.73 | $835.27 | $3,647.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,779.00 / $3,946.00 / $6,988.00
| Facility | | $1,779.00 | $3,946.00 | $6,988.00 |