- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,392.00 / $5,511.00 / $16,900.00
| Facility | | $1,392.00 | $5,511.00 | $16,900.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,943.01 / $2,160.86 / $2,926.29
| Facility | | $1,943.01 | $2,160.86 | $2,926.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,070.25 / $1,070.25 / $1,070.25
| Facility | | $1,070.25 | $1,070.25 | $1,070.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $718.36 / $1,807.00 / $6,184.00
| Facility | | $718.36 | $1,807.00 | $6,184.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $884.00 / $2,900.00 / $5,543.93
| Facility | | $884.00 | $2,900.00 | $5,543.93 |