- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $810.70 / $810.70 / $7,397.00
| Facility | | $810.70 | $810.70 | $7,397.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,680.49 / $10,607.52 / $20,811.61
| Facility | | $3,680.49 | $10,607.52 | $20,811.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,966.51 / $2,790.20 / $6,712.20
| Facility | | $1,966.51 | $2,790.20 | $6,712.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.74 / $2,550.91 / $5,285.20
| Facility | | $1,787.74 | $2,550.91 | $5,285.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $810.70 / $1,376.40 / $5,331.00
| Facility | | $810.70 | $1,376.40 | $5,331.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,940.00 / $7,872.00 / $11,531.00
| Facility | | $3,940.00 | $7,872.00 | $11,531.00 |