- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,545.00 / $5,463.36 / $13,841.56
| Facility | | $1,545.00 | $5,463.36 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,455.14 / $1,898.59 / $3,702.11
| Facility | | $1,455.14 | $1,898.59 | $3,702.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $82.43 / $162.19 / $1,775.00
| Facility | | $82.43 | $162.19 | $1,775.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $108.16 / $199.18 / $265.94
| Facility | | $108.16 | $199.18 | $265.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,056.00 / $1,527.00 / $4,317.00
| Facility | | $1,056.00 | $1,527.00 | $4,317.00 |