- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,019.51 / $7,954.00 / $14,527.91
| Facility | | $1,019.51 | $7,954.00 | $14,527.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,807.00 / $6,653.00 / $11,752.00
| Facility | | $2,807.00 | $6,653.00 | $11,752.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $987.68 / $1,322.25 / $2,000.06
| Facility | | $987.68 | $1,322.25 | $2,000.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $560.00 / $798.00 / $1,627.38
| Facility | | $560.00 | $798.00 | $1,627.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,399.00 / $5,995.00 / $10,413.00
| Facility | | $1,399.00 | $5,995.00 | $10,413.00 |