- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,205.24 / $4,903.00 / $11,627.00
| Facility | | $1,205.24 | $4,903.00 | $11,627.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,830.00 / $3,969.68 / $7,474.03
| Facility | | $1,830.00 | $3,969.68 | $7,474.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,154.57 / $1,385.48 / $1,714.84
| Facility | | $1,154.57 | $1,385.48 | $1,714.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $425.00 / $1,200.00 / $21,571.00
| Facility | | $425.00 | $1,200.00 | $21,571.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $425.00 / $600.00 / $1,378.15
| Facility | | $425.00 | $600.00 | $1,378.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $650.00 / $2,883.00 / $6,111.00
| Facility | | $650.00 | $2,883.00 | $6,111.00 |