- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,001.74 / $9,062.00 / $17,247.00
| Facility | | $1,001.74 | $9,062.00 | $17,247.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,296.60 / $9,339.07 / $16,855.89
| Facility | | $2,296.60 | $9,339.07 | $16,855.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $375.00 / $1,280.00 / $3,845.77
| Facility | | $375.00 | $1,280.00 | $3,845.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $882.06 / $1,170.00 / $1,702.96
| Facility | | $882.06 | $1,170.00 | $1,702.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $990.00 / $15,451.00 / $23,485.00
| Facility | | $990.00 | $15,451.00 | $23,485.00 |