- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,172.60 / $1,547.81 / $13,304.00
| Facility | | $1,172.60 | $1,547.81 | $13,304.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,062.90 / $9,987.00 / $21,322.13
| Facility | | $7,062.90 | $9,987.00 | $21,322.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,281.95 / $1,752.55 / $2,021.70
| Facility | | $1,281.95 | $1,752.55 | $2,021.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,437.60 / $1,541.38 / $1,541.38
| Facility | | $1,437.60 | $1,541.38 | $1,541.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $599.00 / $4,298.00 / $30,001.00
| Facility | | $599.00 | $4,298.00 | $30,001.00 |