- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,195.17 / $2,718.80 / $16,467.00
| Facility | | $1,195.17 | $2,718.80 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,367.00 / $5,636.00 / $9,815.46
| Facility | | $2,367.00 | $5,636.00 | $9,815.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $560.00 / $615.00
| Facility | | $100.00 | $560.00 | $615.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $818.00 / $1,195.17 / $2,031.79
| Facility | | $818.00 | $1,195.17 | $2,031.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $710.00 / $10,069.00 / $16,249.00
| Facility | | $710.00 | $10,069.00 | $16,249.00 |