- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,382.30 / $1,526.14 / $4,846.00
| Facility | | $1,382.30 | $1,526.14 | $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
- $1,271.78 / $1,653.31 / $1,907.67
| Facility | | $1,271.78 | $1,653.31 | $1,907.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $761.00 / $761.00 / $1,635.50
| Facility | | $761.00 | $761.00 | $1,635.50 |
- 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 |