- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,194.00 / $1,551.33 / $13,304.00
| Facility | | $1,194.00 | $1,551.33 | $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
- $1,449.17 / $1,974.42 / $2,277.64
| Facility | | $1,449.17 | $1,974.42 | $2,277.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,492.47 / $1,763.07 / $1,763.07
| Facility | | $1,492.47 | $1,763.07 | $1,763.07 |
- 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 |