- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,588.50 / $3,382.00 / $7,467.00
| Facility | | $1,588.50 | $3,382.00 | $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
- $483.91 / $663.35 / $3,787.00
| Facility | | $483.91 | $663.35 | $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 |