- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,582.00 / $3,437.00 / $7,960.15
| Facility | | $1,582.00 | $3,437.00 | $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
- $1,432.86 / $1,894.75 / $3,104.53
| Facility | | $1,432.86 | $1,894.75 | $3,104.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $353.35 / $1,130.88 / $2,912.00
| Facility | | $353.35 | $1,130.88 | $2,912.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,424.00 / $4,352.00 / $7,217.00
| Facility | | $1,424.00 | $4,352.00 | $7,217.00 |