- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,346.00 / $4,728.00 / $14,100.00
| Facility | | $1,346.00 | $4,728.00 | $14,100.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,085.32 / $6,507.58 / $10,390.44
| Facility | | $4,085.32 | $6,507.58 | $10,390.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,437.08 / $4,437.08 / $4,437.08
| Facility | | $4,437.08 | $4,437.08 | $4,437.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $765.83 / $3,365.00 / $9,412.67
| Facility | | $765.83 | $3,365.00 | $9,412.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,481.00 / $5,407.00 / $9,232.95
| Facility | | $1,481.00 | $5,407.00 | $9,232.95 |