- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,671.00 / $3,617.00 / $7,467.00
| Facility | | $1,671.00 | $3,617.00 | $7,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $672.35 / $2,515.38 / $4,140.09
| Facility | | $672.35 | $2,515.38 | $4,140.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,966.61 / $2,966.61 / $2,966.61
| Facility | | $2,966.61 | $2,966.61 | $2,966.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $219.85 / $296.82 / $3,093.00
| Facility | | $219.85 | $296.82 | $3,093.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,578.00 / $2,567.00 / $5,029.00
| Facility | | $1,578.00 | $2,567.00 | $5,029.00 |