- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,538.00 / $5,297.00 / $8,031.00
| Facility | | $2,538.00 | $5,297.00 | $8,031.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,646.00 / $7,714.00 / $16,131.00
| Facility | | $5,646.00 | $7,714.00 | $16,131.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,020.00 / $6,370.47 / $7,334.38
| Facility | | $1,020.00 | $6,370.47 | $7,334.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $735.56 / $1,277.04 / $2,597.87
| Facility | | $735.56 | $1,277.04 | $2,597.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,048.00 / $7,771.00 / $11,371.00
| Facility | | $1,048.00 | $7,771.00 | $11,371.00 |