- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,520.28 / $2,401.00 / $5,329.00
| Facility | | $1,520.28 | $2,401.00 | $5,329.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $2,555.00 / $5,430.00
| Facility | | $1,000.00 | $2,555.00 | $5,430.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,283.00 / $7,499.00 / $9,374.00
| Facility | | $2,283.00 | $7,499.00 | $9,374.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,412.00 / $1,430.00 / $1,527.00
| Facility | | $1,412.00 | $1,430.00 | $1,527.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,015.00 / $2,095.00 / $9,109.00
| Facility | | $1,015.00 | $2,095.00 | $9,109.00 |