- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,545.00 / $5,463.36 / $13,841.56
| Facility | | $1,545.00 | $5,463.36 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $686.13 / $902.45 / $1,745.64
| Facility | | $686.13 | $902.45 | $1,745.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $67.81 / $118.15 / $1,775.00
| Facility | | $67.81 | $118.15 | $1,775.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $107.10 / $133.09 / $176.38
| Facility | | $107.10 | $133.09 | $176.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,031.00 / $1,775.00 / $4,406.00
| Facility | | $1,031.00 | $1,775.00 | $4,406.00 |