- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,965.00 / $4,474.00 / $7,960.15
| Facility | | $1,965.00 | $4,474.00 | $7,960.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $830.45 / $3,228.01 / $5,113.62
| Facility | | $830.45 | $3,228.01 | $5,113.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $775.00 / $775.00 / $858.00
| Facility | | $775.00 | $775.00 | $858.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $786.26 / $2,791.10 / $8,209.00
| Facility | | $786.26 | $2,791.10 | $8,209.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,500.00 / $6,230.00 / $9,010.00
| Facility | | $4,500.00 | $6,230.00 | $9,010.00 |