- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $591.42 / $591.42 / $6,781.00
| Facility | | $591.42 | $591.42 | $6,781.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,706.64 / $5,293.69 / $10,505.12
| Facility | | $2,706.64 | $5,293.69 | $10,505.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,430.27 / $2,029.35 / $4,881.85
| Facility | | $1,430.27 | $2,029.35 | $4,881.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,300.24 / $1,855.31 / $3,843.99
| Facility | | $1,300.24 | $1,855.31 | $3,843.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $648.54 / $1,022.87 / $1,776.64
| Facility | | $648.54 | $1,022.87 | $1,776.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,457.00 / $9,370.00 / $12,774.00
| Facility | | $5,457.00 | $9,370.00 | $12,774.00 |