- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,324.00 / $4,182.00 / $7,960.15
| Facility | | $1,324.00 | $4,182.00 | $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 / $1,567.87 / $2,568.94
| Facility | | $630.00 | $1,567.87 | $2,568.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $219.26 / $269.17 / $3,008.00
| Facility | | $219.26 | $269.17 | $3,008.00 |
- 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 |