- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,073.33 / $1,140.27 / $8,229.00
| Facility | | $1,073.33 | $1,140.27 | $8,229.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,923.72 / $7,537.12 / $11,845.28
| Facility | | $3,923.72 | $7,537.12 | $11,845.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,045.85 / $1,435.49 / $1,655.95
| Facility | | $1,045.85 | $1,435.49 | $1,655.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,261.02 / $1,261.02 / $1,261.02
| Facility | | $1,261.02 | $1,261.02 | $1,261.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $847.00 / $1,475.00 / $12,296.00
| Facility | | $847.00 | $1,475.00 | $12,296.00 |