- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,112.57 / $2,859.30 / $14,063.00
| Facility | | $1,112.57 | $2,859.30 | $14,063.00 |
- 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
- $1,077.99 / $1,443.17 / $2,182.94
| Facility | | $1,077.99 | $1,443.17 | $2,182.94 |
- 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 |