- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,691.00 / $3,617.00 / $7,467.00
| Facility | | $1,691.00 | $3,617.00 | $7,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,763.75 / $6,598.50 / $10,860.55
| Facility | | $1,763.75 | $6,598.50 | $10,860.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,049.52 / $3,049.52 / $3,049.52
| Facility | | $3,049.52 | $3,049.52 | $3,049.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $319.38 / $468.16 / $3,790.00
| Facility | | $319.38 | $468.16 | $3,790.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,343.00 / $3,339.00 / $5,838.00
| Facility | | $2,343.00 | $3,339.00 | $5,838.00 |