- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,653.00 / $4,507.13 / $12,036.14
| Facility | | $1,653.00 | $4,507.13 | $12,036.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,279.80 / $7,654.23 / $13,432.67
| Facility | | $5,279.80 | $7,654.23 | $13,432.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $332.24 / $626.99 / $4,217.00
| Facility | | $332.24 | $626.99 | $4,217.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $667.34 / $950.50 / $3,282.67
| Facility | | $667.34 | $950.50 | $3,282.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,217.00 / $6,451.00 / $7,934.00
| Facility | | $4,217.00 | $6,451.00 | $7,934.00 |