- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $668.07 / $668.07 / $10,204.23
| Facility | | $668.07 | $668.07 | $10,204.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,036.08 / $5,939.08 / $11,966.76
| Facility | | $3,036.08 | $5,939.08 | $11,966.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,625.57 / $2,306.44 / $5,548.49
| Facility | | $1,625.57 | $2,306.44 | $5,548.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,477.79 / $2,108.65 / $4,368.89
| Facility | | $1,477.79 | $2,108.65 | $4,368.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $678.82 / $1,144.71 / $3,991.00
| Facility | | $678.82 | $1,144.71 | $3,991.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,121.00 / $5,499.00 / $9,810.00
| Facility | | $3,121.00 | $5,499.00 | $9,810.00 |