- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,545.00 / $3,908.01 / $13,841.56
| Facility | | $1,545.00 | $3,908.01 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,724.93 / $4,899.30 / $9,476.84
| Facility | | $3,724.93 | $4,899.30 | $9,476.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $108.39 / $515.76 / $3,586.95
| Facility | | $108.39 | $515.76 | $3,586.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $197.04 / $292.88 / $1,264.80
| Facility | | $197.04 | $292.88 | $1,264.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,775.00 / $3,227.00 / $6,169.00
| Facility | | $1,775.00 | $3,227.00 | $6,169.00 |