- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,965.00 / $3,758.00 / $7,467.00
| Facility | | $1,965.00 | $3,758.00 | $7,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $672.35 / $2,515.38 / $4,140.09
| Facility | | $672.35 | $2,515.38 | $4,140.09 |
- 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
- $242.25 / $332.08 / $3,787.00
| Facility | | $242.25 | $332.08 | $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 |