- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,293.44 / $1,443.63 / $8,229.00
| Facility | | $1,293.44 | $1,443.63 | $8,229.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,049.25 / $9,122.94 / $15,243.15
| Facility | | $5,049.25 | $9,122.94 | $15,243.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,338.64 / $1,837.35 / $2,119.51
| Facility | | $1,338.64 | $1,837.35 | $2,119.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,647.91 / $1,647.91 / $1,647.91
| Facility | | $1,647.91 | $1,647.91 | $1,647.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $405.00 / $2,513.00 / $27,879.00
| Facility | | $405.00 | $2,513.00 | $27,879.00 |