- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,671.00 / $4,873.00 / $10,706.72
| Facility | | $1,671.00 | $4,873.00 | $10,706.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $632.79 / $2,362.71 / $4,140.09
| Facility | | $632.79 | $2,362.71 | $4,140.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,188.66 / $1,571.83 / $2,575.42
| Facility | | $1,188.66 | $1,571.83 | $2,575.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $361.47 / $447.24 / $4,352.00
| Facility | | $361.47 | $447.24 | $4,352.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,912.00 / $4,702.00 / $7,217.00
| Facility | | $2,912.00 | $4,702.00 | $7,217.00 |