- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,671.00 / $3,437.00 / $7,960.15
| Facility | | $1,671.00 | $3,437.00 | $7,960.15 |
- 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
- $1,594.95 / $2,109.10 / $3,455.73
| Facility | | $1,594.95 | $2,109.10 | $3,455.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $354.06 / $472.22 / $3,627.00
| Facility | | $354.06 | $472.22 | $3,627.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $845.00 / $3,205.00 / $5,133.00
| Facility | | $845.00 | $3,205.00 | $5,133.00 |