- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,582.00 / $3,055.00 / $7,562.14
| Facility | | $1,582.00 | $3,055.00 | $7,562.14 |
- 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
- $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
- $412.19 / $526.35 / $3,627.00
| Facility | | $412.19 | $526.35 | $3,627.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $845.00 / $3,205.00 / $5,133.00
| Facility | | $845.00 | $3,205.00 | $5,133.00 |