- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,274.86 / $7,352.68 / $12,105.60
| Facility | | $1,274.86 | $7,352.68 | $12,105.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,300.00 / $4,454.50 / $9,081.16
| Facility | | $1,300.00 | $4,454.50 | $9,081.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $375.00 / $655.00 / $1,842.86
| Facility | | $375.00 | $655.00 | $1,842.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $483.01 / $619.07 / $988.68
| Facility | | $483.01 | $619.07 | $988.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $710.00 / $10,069.00 / $16,249.00
| Facility | | $710.00 | $10,069.00 | $16,249.00 |