- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,194.00 / $1,492.25 / $13,304.00
| Facility | | $1,194.00 | $1,492.25 | $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
- $1,383.72 / $1,899.23 / $2,190.89
| Facility | | $1,383.72 | $1,899.23 | $2,190.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,417.42 / $1,688.87 / $1,688.87
| Facility | | $1,417.42 | $1,688.87 | $1,688.87 |
- 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 |