- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,965.00 / $4,781.00 / $8,447.00
| Facility | | $1,965.00 | $4,781.00 | $8,447.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,341.54 / $4,903.56 / $8,070.83
| Facility | | $1,341.54 | $4,903.56 | $8,070.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,269.46 / $5,269.46 / $5,269.46
| Facility | | $5,269.46 | $5,269.46 | $5,269.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $661.83 / $942.29 / $9,383.00
| Facility | | $661.83 | $942.29 | $9,383.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,315.00 / $7,341.00 / $11,396.00
| Facility | | $5,315.00 | $7,341.00 | $11,396.00 |