- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,671.00 / $4,521.00 / $8,326.00
| Facility | | $1,671.00 | $4,521.00 | $8,326.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,310.70 / $4,903.56 / $8,070.83
| Facility | | $1,310.70 | $4,903.56 | $8,070.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,084.43 / $3,084.43 / $3,084.43
| Facility | | $3,084.43 | $3,084.43 | $3,084.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $612.36 / $847.93 / $3,787.00
| Facility | | $612.36 | $847.93 | $3,787.00 |
- 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 |