- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,405.50 / $5,467.00 / $12,237.00
| Facility | | $1,405.50 | $5,467.00 | $12,237.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,444.00 / $7,658.93 / $9,010.51
| Facility | | $1,444.00 | $7,658.93 | $9,010.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,199.00 / $4,914.00 / $9,647.00
| Facility | | $2,199.00 | $4,914.00 | $9,647.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $748.53 / $1,006.75 / $5,766.00
| Facility | | $748.53 | $1,006.75 | $5,766.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,405.00 / $3,647.00 / $6,988.00
| Facility | | $1,405.00 | $3,647.00 | $6,988.00 |