- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,070.00 / $3,008.00 / $7,562.14
| Facility | | $1,070.00 | $3,008.00 | $7,562.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $552.79 / $2,064.02 / $3,616.69
| Facility | | $552.79 | $2,064.02 | $3,616.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.00 / $1,571.83 / $2,575.42
| Facility | | $446.00 | $1,571.83 | $2,575.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $422.05 / $555.92 / $2,086.00
| Facility | | $422.05 | $555.92 | $2,086.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $966.00 / $2,517.00 / $4,486.00
| Facility | | $966.00 | $2,517.00 | $4,486.00 |