- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,671.00 / $3,745.00 / $7,467.00
| Facility | | $1,671.00 | $3,745.00 | $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
- $4,100.10 / $4,100.10 / $4,100.10
| Facility | | $4,100.10 | $4,100.10 | $4,100.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $328.83 / $454.15 / $7,168.00
| Facility | | $328.83 | $454.15 | $7,168.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,209.10 / $5,596.00 / $8,586.00
| Facility | | $4,209.10 | $5,596.00 | $8,586.00 |