- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,610.49 / $3,658.26 / $16,467.00
| Facility | | $1,610.49 | $3,658.26 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,911.48 / $6,688.18 / $7,315.41
| Facility | | $5,911.48 | $6,688.18 | $7,315.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $560.00 / $615.00
| Facility | | $100.00 | $560.00 | $615.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,259.78 / $1,610.49 / $2,759.83
| Facility | | $1,259.78 | $1,610.49 | $2,759.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $454.00 / $6,074.00 / $8,818.00
| Facility | | $454.00 | $6,074.00 | $8,818.00 |