- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616.60 / $616.60 / $5,011.87
| Facility | | $616.60 | $616.60 | $5,011.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,715.35 / $6,760.83 / $13,803.84
| Facility | | $3,715.35 | $6,760.83 | $13,803.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $2,238.72 / $5,370.32
| Facility | | $1,584.89 | $2,238.72 | $5,370.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,737.80 / $2,187.76 / $4,265.80
| Facility | | $1,737.80 | $2,187.76 | $4,265.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $645.65 / $1,047.13 / $4,677.35
| Facility | | $645.65 | $1,047.13 | $4,677.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $3,467.37 / $7,413.10
| Facility | | $1,000.00 | $3,467.37 | $7,413.10 |