- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,077.74 / $1,729.67 / $13,304.00
| Facility | | $1,077.74 | $1,729.67 | $13,304.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,104.00 / $5,280.00 / $12,101.00
| Facility | | $3,104.00 | $5,280.00 | $12,101.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,307.81 / $1,795.04 / $2,070.69
| Facility | | $1,307.81 | $1,795.04 | $2,070.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.80 / $1,584.80 / $1,584.80
| Facility | | $1,584.80 | $1,584.80 | $1,584.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $719.00 / $1,298.00 / $10,113.00
| Facility | | $719.00 | $1,298.00 | $10,113.00 |