- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,194.00 / $2,034.87 / $13,304.00
| Facility | | $1,194.00 | $2,034.87 | $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
- $1,726.57 / $2,360.16 / $2,722.62
| Facility | | $1,726.57 | $2,360.16 | $2,722.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,011.05 / $2,080.21 / $2,080.21
| Facility | | $2,011.05 | $2,080.21 | $2,080.21 |
- 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 |