- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,274.00 / $4,362.17 / $10,439.00
| Facility | | $1,274.00 | $4,362.17 | $10,439.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $674.00 / $1,375.39 / $1,557.87
| Facility | | $674.00 | $1,375.39 | $1,557.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $800.00 / $1,098.00 / $2,437.00
| Facility | | $800.00 | $1,098.00 | $2,437.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $204.04 / $341.51 / $3,019.00
| Facility | | $204.04 | $341.51 | $3,019.00 |
- 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 |