- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $481.25 / $580.38 / $3,638.00
| Facility | | $481.25 | $580.38 | $3,638.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,737.07 / $3,346.04 / $6,480.74
| Facility | | $1,737.07 | $3,346.04 | $6,480.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,466.38 / $2,079.51 / $5,002.55
| Facility | | $1,466.38 | $2,079.51 | $5,002.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,192.06 / $1,901.17 / $3,939.01
| Facility | | $1,192.06 | $1,901.17 | $3,939.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $757.20 / $1,021.50 / $4,637.00
| Facility | | $757.20 | $1,021.50 | $4,637.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,296.00 / $3,500.00 / $6,361.00
| Facility | | $2,296.00 | $3,500.00 | $6,361.00 |