- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,540.01 / $5,228.00 / $12,237.00
| Facility | | $1,540.01 | $5,228.00 | $12,237.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,753.70 / $4,532.06 / $5,383.30
| Facility | | $1,753.70 | $4,532.06 | $5,383.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $624.00 / $8,660.00 / $8,660.00
| Facility | | $624.00 | $8,660.00 | $8,660.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,005.85 / $1,602.21 / $6,969.00
| Facility | | $1,005.85 | $1,602.21 | $6,969.00 |
- 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 |