- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,116.93 / $1,394.46 / $13,304.00
| Facility | | $1,116.93 | $1,394.46 | $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
- $1,238.36 / $1,688.81 / $1,948.17
| Facility | | $1,238.36 | $1,688.81 | $1,948.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,408.53 / $1,503.96 / $1,503.96
| Facility | | $1,408.53 | $1,503.96 | $1,503.96 |
- 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 |