- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $562.84 / $562.84 / $6,781.00
| Facility | | $562.84 | $562.84 | $6,781.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,423.56 / $5,939.08 / $11,966.76
| Facility | | $2,423.56 | $5,939.08 | $11,966.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,367.13 / $1,939.76 / $4,666.35
| Facility | | $1,367.13 | $1,939.76 | $4,666.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,242.84 / $1,773.41 / $3,674.30
| Facility | | $1,242.84 | $1,773.41 | $3,674.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $608.64 / $983.50 / $3,293.00
| Facility | | $608.64 | $983.50 | $3,293.00 |
- 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 |