- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,582.00 / $2,897.00 / $6,483.00
| Facility | | $1,582.00 | $2,897.00 | $6,483.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $552.79 / $2,064.02 / $3,616.69
| Facility | | $552.79 | $2,064.02 | $3,616.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.00 / $1,571.83 / $2,575.42
| Facility | | $446.00 | $1,571.83 | $2,575.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $452.50 / $643.70 / $2,086.00
| Facility | | $452.50 | $643.70 | $2,086.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $966.00 / $2,338.31 / $4,466.00
| Facility | | $966.00 | $2,338.31 | $4,466.00 |