- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,965.00 / $4,474.00 / $7,960.15
| Facility | | $1,965.00 | $4,474.00 | $7,960.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $781.60 / $2,918.30 / $5,113.62
| Facility | | $781.60 | $2,918.30 | $5,113.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.00 / $3,280.17 / $5,374.52
| Facility | | $630.00 | $3,280.17 | $5,374.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $786.25 / $1,140.29 / $3,612.00
| Facility | | $786.25 | $1,140.29 | $3,612.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $845.00 / $3,311.00 / $5,133.00
| Facility | | $845.00 | $3,311.00 | $5,133.00 |