- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,385.54 / $1,854.00 / $16,042.00
| Facility | | $1,385.54 | $1,854.00 | $16,042.00 |
- 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
- $1,278.56 / $1,662.13 / $1,917.84
| Facility | | $1,278.56 | $1,662.13 | $1,917.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $761.00 / $761.00 / $1,648.88
| Facility | | $761.00 | $761.00 | $1,648.88 |
- 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 |