- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,082.00 / $2,540.25 / $5,506.00
| Facility | | $1,082.00 | $2,540.25 | $5,506.00 |
- 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
- $538.19 / $711.68 / $1,166.08
| Facility | | $538.19 | $711.68 | $1,166.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $154.96 / $1,424.00 / $3,577.13
| Facility | | $154.96 | $1,424.00 | $3,577.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $966.00 / $2,499.00 / $4,486.00
| Facility | | $966.00 | $2,499.00 | $4,486.00 |