- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,522.64 / $1,698.13 / $4,846.00
| Facility | | $1,522.64 | $1,698.13 | $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
- $1,443.41 / $1,839.64 / $2,122.67
| Facility | | $1,443.41 | $1,839.64 | $2,122.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $761.00 / $761.00 / $1,831.07
| Facility | | $761.00 | $761.00 | $1,831.07 |
- 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 |