- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,070.00 / $2,640.00 / $6,060.00
| Facility | | $1,070.00 | $2,640.00 | $6,060.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $412.80 / $1,541.29 / $2,700.74
| Facility | | $412.80 | $1,541.29 | $2,700.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $333.00 / $1,571.83 / $2,575.42
| Facility | | $333.00 | $1,571.83 | $2,575.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $270.61 / $350.14 / $1,900.00
| Facility | | $270.61 | $350.14 | $1,900.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $966.00 / $2,517.00 / $4,486.00
| Facility | | $966.00 | $2,517.00 | $4,486.00 |