- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,679.18 / $5,934.00 / $11,581.00
| Facility | | $1,679.18 | $5,934.00 | $11,581.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,084.00 / $4,437.00 / $19,117.00
| Facility | | $2,084.00 | $4,437.00 | $19,117.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,354.98 / $1,661.15 / $4,302.13
| Facility | | $1,354.98 | $1,661.15 | $4,302.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,261.61 / $3,169.47 / $21,571.00
| Facility | | $1,261.61 | $3,169.47 | $21,571.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,169.47 / $3,534.33 / $4,869.66
| Facility | | $3,169.47 | $3,534.33 | $4,869.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,206.00 / $5,605.00 / $9,483.00
| Facility | | $3,206.00 | $5,605.00 | $9,483.00 |