- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,671.00 / $4,521.00 / $12,904.60
| Facility | | $1,671.00 | $4,521.00 | $12,904.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $601.16 / $2,211.19 / $3,616.69
| Facility | | $601.16 | $2,211.19 | $3,616.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,807.43 / $1,807.43 / $1,807.43
| Facility | | $1,807.43 | $1,807.43 | $1,807.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $354.08 / $569.09 / $3,269.00
| Facility | | $354.08 | $569.09 | $3,269.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,559.72 / $2,482.00 / $4,486.00
| Facility | | $1,559.72 | $2,482.00 | $4,486.00 |