- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,627.98 / $5,201.00 / $11,627.00
| Facility | | $1,627.98 | $5,201.00 | $11,627.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,152.00 / $3,025.00 / $8,800.00
| Facility | | $1,152.00 | $3,025.00 | $8,800.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,309.02 / $1,604.81 / $1,963.53
| Facility | | $1,309.02 | $1,604.81 | $1,963.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,124.08 / $1,223.97 / $21,571.00
| Facility | | $1,124.08 | $1,223.97 | $21,571.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,124.08 / $1,124.08 / $1,253.49
| Facility | | $1,124.08 | $1,124.08 | $1,253.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,233.00 / $4,321.00 / $7,351.00
| Facility | | $2,233.00 | $4,321.00 | $7,351.00 |