- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,060.48 / $5,135.00 / $10,817.74
| Facility | | $1,060.48 | $5,135.00 | $10,817.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,145.00 / $2,792.00 / $8,800.00
| Facility | | $1,145.00 | $2,792.00 | $8,800.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $859.16 / $1,053.30 / $1,289.18
| Facility | | $859.16 | $1,053.30 | $1,289.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $796.88 / $949.77 / $21,571.00
| Facility | | $796.88 | $949.77 | $21,571.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $949.77 / $949.77 / $1,059.09
| Facility | | $949.77 | $949.77 | $1,059.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,233.00 / $4,321.00 / $7,351.00
| Facility | | $2,233.00 | $4,321.00 | $7,351.00 |