- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,582.00 / $3,008.00 / $6,483.00
| Facility | | $1,582.00 | $3,008.00 | $6,483.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,660.00 / $6,198.03 / $10,860.55
| Facility | | $1,660.00 | $6,198.03 | $10,860.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,188.66 / $1,571.83 / $2,575.42
| Facility | | $1,188.66 | $1,571.83 | $2,575.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $867.49 / $1,077.59 / $4,635.00
| Facility | | $867.49 | $1,077.59 | $4,635.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,338.31 / $3,847.00 / $7,217.00
| Facility | | $2,338.31 | $3,847.00 | $7,217.00 |