- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,022.34 / $1,283.46 / $13,304.00
| Facility | | $1,022.34 | $1,283.46 | $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
- $1,125.55 / $1,544.87 / $1,782.12
| Facility | | $1,125.55 | $1,544.87 | $1,782.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,296.41 / $1,374.22 / $1,374.22
| Facility | | $1,296.41 | $1,374.22 | $1,374.22 |
- 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 |