- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,582.00 / $3,617.00 / $8,104.00
| Facility | | $1,582.00 | $3,617.00 | $8,104.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $601.16 / $2,465.48 / $3,616.69
| Facility | | $601.16 | $2,465.48 | $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
- $419.91 / $687.97 / $3,269.00
| Facility | | $419.91 | $687.97 | $3,269.00 |
- 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 |