- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,411.00 / $5,297.00 / $8,031.00
| Facility | | $2,411.00 | $5,297.00 | $8,031.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $816.76 / $8,217.00 / $11,908.00
| Facility | | $816.76 | $8,217.00 | $11,908.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $998.00 / $3,113.54 / $3,584.65
| Facility | | $998.00 | $3,113.54 | $3,584.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,277.04 / $2,468.46 / $2,597.87
| Facility | | $1,277.04 | $2,468.46 | $2,597.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,048.00 / $7,771.00 / $11,371.00
| Facility | | $1,048.00 | $7,771.00 | $11,371.00 |