- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $222.55 / $450.18 / $4,557.00
| Facility | | $222.55 | $450.18 | $4,557.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,729.69 / $5,792.97 / $11,146.35
| Facility | | $2,729.69 | $5,792.97 | $11,146.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,084.28 / $1,538.43 / $3,700.91
| Facility | | $1,084.28 | $1,538.43 | $3,700.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $881.89 / $1,406.50 / $2,914.10
| Facility | | $881.89 | $1,406.50 | $2,914.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $232.38 / $507.00 / $1,197.24
| Facility | | $232.38 | $507.00 | $1,197.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,412.00 / $4,746.00 / $8,812.00
| Facility | | $2,412.00 | $4,746.00 | $8,812.00 |