- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,386.00 / $1,619.69 / $11,093.00
| Facility | | $1,386.00 | $1,619.69 | $11,093.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,600.00 / $8,980.45 / $14,278.45
| Facility | | $4,600.00 | $8,980.45 | $14,278.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,349.74 / $1,754.66 / $2,024.61
| Facility | | $1,349.74 | $1,754.66 | $2,024.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $761.00 / $761.00 / $1,719.01
| Facility | | $761.00 | $761.00 | $1,719.01 |
- 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 |