- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,582.00 / $2,912.00 / $6,483.00
| Facility | | $1,582.00 | $2,912.00 | $6,483.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,341.54 / $4,934.39 / $8,070.83
| Facility | | $1,341.54 | $4,934.39 | $8,070.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,165.05 / $1,165.05 / $1,165.05
| Facility | | $1,165.05 | $1,165.05 | $1,165.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $238.77 / $425.44 / $2,735.00
| Facility | | $238.77 | $425.44 | $2,735.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,068.00 / $1,711.00 / $3,268.00
| Facility | | $1,068.00 | $1,711.00 | $3,268.00 |