- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,580.75 / $2,933.00 / $6,483.00
| Facility | | $1,580.75 | $2,933.00 | $6,483.00 |
- 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
- $796.23 / $1,018.20 / $4,860.00
| Facility | | $796.23 | $1,018.20 | $4,860.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,788.00 / $3,847.00 / $7,217.00
| Facility | | $2,788.00 | $3,847.00 | $7,217.00 |