- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,965.00 / $3,819.00 / $7,467.00
| Facility | | $1,965.00 | $3,819.00 | $7,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $688.17 / $2,531.19 / $4,140.09
| Facility | | $688.17 | $2,531.19 | $4,140.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,544.38 / $5,544.38 / $5,544.38
| Facility | | $5,544.38 | $5,544.38 | $5,544.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $395.23 / $1,209.65 / $8,317.00
| Facility | | $395.23 | $1,209.65 | $8,317.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,315.00 / $7,341.00 / $11,396.00
| Facility | | $5,315.00 | $7,341.00 | $11,396.00 |