- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,305.57 / $1,664.48 / $8,229.00
| Facility | | $1,305.57 | $1,664.48 | $8,229.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,720.89 / $10,099.00 / $25,551.65
| Facility | | $7,720.89 | $10,099.00 | $25,551.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,273.81 / $1,748.36 / $2,016.87
| Facility | | $1,273.81 | $1,748.36 | $2,016.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,536.49 / $1,536.49 / $1,536.49
| Facility | | $1,536.49 | $1,536.49 | $1,536.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.00 / $945.00 / $6,295.00
| Facility | | $575.00 | $945.00 | $6,295.00 |