- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,194.00 / $1,527.06 / $8,229.00
| Facility | | $1,194.00 | $1,527.06 | $8,229.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,350.00 / $26,902.00 / $33,627.00
| Facility | | $5,350.00 | $26,902.00 | $33,627.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,275.57 / $1,739.30 / $2,006.42
| Facility | | $1,275.57 | $1,739.30 | $2,006.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,529.72 / $1,529.72 / $1,625.71
| Facility | | $1,529.72 | $1,529.72 | $1,625.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,300.00 / $6,818.00 / $16,703.00
| Facility | | $1,300.00 | $6,818.00 | $16,703.00 |