- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,965.00 / $4,521.00 / $7,960.15
| Facility | | $1,965.00 | $4,521.00 | $7,960.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $781.60 / $2,918.30 / $5,113.62
| Facility | | $781.60 | $2,918.30 | $5,113.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.00 / $1,571.83 / $2,575.42
| Facility | | $630.00 | $1,571.83 | $2,575.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $486.28 / $645.28 / $4,352.00
| Facility | | $486.28 | $645.28 | $4,352.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,338.31 / $3,847.00 / $7,217.00
| Facility | | $2,338.31 | $3,847.00 | $7,217.00 |