- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,965.00 / $4,474.00 / $7,960.15
| Facility | | $1,965.00 | $4,474.00 | $7,960.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $552.79 / $2,064.02 / $3,616.69
| Facility | | $552.79 | $2,064.02 | $3,616.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,432.06 / $3,216.04 / $5,269.46
| Facility | | $2,432.06 | $3,216.04 | $5,269.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $737.59 / $1,684.53 / $7,104.00
| Facility | | $737.59 | $1,684.53 | $7,104.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,100.00 / $7,104.00 / $11,396.00
| Facility | | $4,100.00 | $7,104.00 | $11,396.00 |