- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,312.02 / $1,446.71 / $4,846.00
| Facility | | $1,312.02 | $1,446.71 | $4,846.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,600.00 / $11,226.46 / $15,429.17
| Facility | | $4,600.00 | $11,226.46 | $15,429.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,205.58 / $1,567.27 / $1,808.39
| Facility | | $1,205.58 | $1,567.27 | $1,808.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $761.00 / $761.00 / $1,549.57
| Facility | | $761.00 | $761.00 | $1,549.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $612.00 / $5,076.00 / $10,396.00
| Facility | | $612.00 | $5,076.00 | $10,396.00 |