- 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
- $830.45 / $3,106.86 / $5,113.62
| Facility | | $830.45 | $3,106.86 | $5,113.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,768.35 / $1,768.35 / $1,768.35
| Facility | | $1,768.35 | $1,768.35 | $1,768.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.28 / $665.88 / $2,649.00
| Facility | | $467.28 | $665.88 | $2,649.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,068.00 / $1,711.00 / $3,268.00
| Facility | | $1,068.00 | $1,711.00 | $3,268.00 |