- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,566.24 / $1,732.26 / $4,846.00
| Facility | | $1,566.24 | $1,732.26 | $4,846.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,600.00 / $11,226.46 / $15,429.17
| Facility | | $4,600.00 | $11,226.46 | $15,429.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,443.55 / $1,876.62 / $2,165.33
| Facility | | $1,443.55 | $1,876.62 | $2,165.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $761.00 / $761.00 / $1,863.80
| Facility | | $761.00 | $761.00 | $1,863.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $612.00 / $5,076.00 / $10,396.00
| Facility | | $612.00 | $5,076.00 | $10,396.00 |