- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,862.00 / $7,137.50 / $8,808.31
| Facility | | $2,862.00 | $7,137.50 | $8,808.31 |
- 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
- $807.91 / $1,023.56 / $2,255.33
| Facility | | $807.91 | $1,023.56 | $2,255.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $833.00 / $6,639.00 / $9,973.00
| Facility | | $833.00 | $6,639.00 | $9,973.00 |