- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,582.00 / $2,933.00 / $6,483.00
| Facility | | $1,582.00 | $2,933.00 | $6,483.00 |
- 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
- $3,698.51 / $3,698.51 / $3,698.51
| Facility | | $3,698.51 | $3,698.51 | $3,698.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $208.02 / $481.26 / $5,541.00
| Facility | | $208.02 | $481.26 | $5,541.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,912.00 / $4,545.00 / $7,217.00
| Facility | | $2,912.00 | $4,545.00 | $7,217.00 |