- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,965.00 / $3,382.00 / $7,467.00
| Facility | | $1,965.00 | $3,382.00 | $7,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $552.79 / $2,064.02 / $3,616.69
| Facility | | $552.79 | $2,064.02 | $3,616.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,024.58 / $2,677.21 / $4,386.59
| Facility | | $2,024.58 | $2,677.21 | $4,386.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $218.06 / $315.64 / $3,008.00
| Facility | | $218.06 | $315.64 | $3,008.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $845.00 / $3,311.00 / $5,133.00
| Facility | | $845.00 | $3,311.00 | $5,133.00 |