- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,965.00 / $4,521.00 / $7,960.15
| Facility | | $1,965.00 | $4,521.00 | $7,960.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $944.35 / $3,532.98 / $5,814.97
| Facility | | $944.35 | $3,532.98 | $5,814.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,469.03 / $4,469.03 / $4,469.03
| Facility | | $4,469.03 | $4,469.03 | $4,469.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $354.44 / $473.85 / $3,787.00
| Facility | | $354.44 | $473.85 | $3,787.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,343.00 / $3,339.00 / $5,838.00
| Facility | | $2,343.00 | $3,339.00 | $5,838.00 |