- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $727.73 / $727.73 / $7,397.00
| Facility | | $727.73 | $727.73 | $7,397.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,082.77 / $6,102.01 / $11,903.07
| Facility | | $3,082.77 | $6,102.01 | $11,903.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,765.32 / $2,504.73 / $6,025.47
| Facility | | $1,765.32 | $2,504.73 | $6,025.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,604.83 / $2,289.92 / $4,744.46
| Facility | | $1,604.83 | $2,289.92 | $4,744.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $742.54 / $1,253.01 / $3,312.00
| Facility | | $742.54 | $1,253.01 | $3,312.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,412.00 / $3,756.00 / $8,193.00
| Facility | | $2,412.00 | $3,756.00 | $8,193.00 |