- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $266.89 / $2,447.48 / $4,806.64
| Facility | | $266.89 | $2,447.48 | $4,806.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $451.88 / $2,854.00 / $9,039.00
| Facility | | $451.88 | $2,854.00 | $9,039.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $216.75 / $281.77 / $544.21
| Facility | | $216.75 | $281.77 | $544.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $186.93 / $395.22 / $6,679.00
| Facility | | $186.93 | $395.22 | $6,679.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,151.76 / $4,341.72 / $6,079.20
| Facility | | $4,151.76 | $4,341.72 | $6,079.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,262.52 / $3,764.00 / $26,542.00
| Facility | | $1,262.52 | $3,764.00 | $26,542.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,902.00 / $3,764.00 / $8,766.00
| Facility | | $1,902.00 | $3,764.00 | $8,766.00 |