- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,249.44 / $5,201.00 / $11,627.00
| Facility | | $1,249.44 | $5,201.00 | $11,627.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,778.00 / $8,483.00 / $60,320.00
| Facility | | $2,778.00 | $8,483.00 | $60,320.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,008.44 / $1,236.30 / $2,364.77
| Facility | | $1,008.44 | $1,236.30 | $2,364.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $938.76 / $1,742.17 / $21,571.00
| Facility | | $938.76 | $1,742.17 | $21,571.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,742.17 / $1,742.17 / $1,942.72
| Facility | | $1,742.17 | $1,742.17 | $1,942.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,912.00 / $6,231.00 / $10,075.00
| Facility | | $2,912.00 | $6,231.00 | $10,075.00 |