- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,308.92 / $7,742.61 / $11,627.00
| Facility | | $2,308.92 | $7,742.61 | $11,627.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,802.00 / $13,811.09 / $24,478.90
| Facility | | $2,802.00 | $13,811.09 | $24,478.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,199.04 / $2,638.85 / $3,266.15
| Facility | | $2,199.04 | $2,638.85 | $3,266.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $425.00 / $1,200.00 / $21,571.00
| Facility | | $425.00 | $1,200.00 | $21,571.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $425.00 / $600.00 / $2,649.47
| Facility | | $425.00 | $600.00 | $2,649.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $650.00 / $2,883.00 / $6,111.00
| Facility | | $650.00 | $2,883.00 | $6,111.00 |