- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,059.49 / $1,262.32 / $13,304.00
| Facility | | $1,059.49 | $1,262.32 | $13,304.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,104.00 / $5,280.00 / $12,101.00
| Facility | | $3,104.00 | $5,280.00 | $12,101.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,181.65 / $1,606.58 / $1,853.32
| Facility | | $1,181.65 | $1,606.58 | $1,853.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,120.57 / $1,437.97 / $1,437.97
| Facility | | $1,120.57 | $1,437.97 | $1,437.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $842.00 / $4,539.00 / $10,113.00
| Facility | | $842.00 | $4,539.00 | $10,113.00 |