- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,175.00 / $3,891.00 / $12,154.00
| Facility | | $1,175.00 | $3,891.00 | $12,154.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,093.79 / $2,927.13 / $3,941.65
| Facility | | $1,093.79 | $2,927.13 | $3,941.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,982.00 / $2,399.00 / $8,757.00
| Facility | | $1,982.00 | $2,399.00 | $8,757.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $338.15 / $564.13 / $2,902.00
| Facility | | $338.15 | $564.13 | $2,902.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,037.00 / $3,096.00 / $5,562.00
| Facility | | $1,037.00 | $3,096.00 | $5,562.00 |