- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,511.00 / $4,387.00 / $10,439.00
| Facility | | $1,511.00 | $4,387.00 | $10,439.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $457.00 / $915.36 / $1,298.53
| Facility | | $457.00 | $915.36 | $1,298.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $993.00 / $1,098.00 / $2,437.00
| Facility | | $993.00 | $1,098.00 | $2,437.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $262.89 / $1,121.63 / $2,226.17
| Facility | | $262.89 | $1,121.63 | $2,226.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $816.00 / $2,081.00 / $3,918.00
| Facility | | $816.00 | $2,081.00 | $3,918.00 |