- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,262.91 / $3,508.40 / $9,391.62
| Facility | | $1,262.91 | $3,508.40 | $9,391.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,888.00 / $5,098.78 / $9,143.61
| Facility | | $1,888.00 | $5,098.78 | $9,143.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $375.00 / $810.00 / $1,842.86
| Facility | | $375.00 | $810.00 | $1,842.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $472.58 / $568.94 / $972.03
| Facility | | $472.58 | $568.94 | $972.03 |
- 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 |