- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,048.00 / $3,803.00 / $12,600.00
| Facility | | $1,048.00 | $3,803.00 | $12,600.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,813.00 / $12,134.35 / $18,991.72
| Facility | | $7,813.00 | $12,134.35 | $18,991.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,321.00 / $8,274.00 / $8,274.00
| Facility | | $2,321.00 | $8,274.00 | $8,274.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $945.75 / $1,345.08 / $10,793.00
| Facility | | $945.75 | $1,345.08 | $10,793.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,157.00 / $4,683.00 / $33,741.00
| Facility | | $1,157.00 | $4,683.00 | $33,741.00 |