- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,416.80 / $3,617.00 / $7,467.00
| Facility | | $1,416.80 | $3,617.00 | $7,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $672.35 / $2,613.46 / $4,140.09
| Facility | | $672.35 | $2,613.46 | $4,140.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $600.00 / $600.00 / $697.00
| Facility | | $600.00 | $600.00 | $697.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $659.67 / $1,523.00 / $7,047.00
| Facility | | $659.67 | $1,523.00 | $7,047.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,021.00 / $4,545.00 / $7,217.00
| Facility | | $3,021.00 | $4,545.00 | $7,217.00 |