- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $436.52 / $436.52 / $6,760.83
| Facility | | $436.52 | $436.52 | $6,760.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,570.40 / $6,456.54 / $14,791.08
| Facility | | $2,570.40 | $6,456.54 | $14,791.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,148.15 / $1,621.81 / $3,801.89
| Facility | | $1,148.15 | $1,621.81 | $3,801.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,230.27 / $1,548.82 / $3,019.95
| Facility | | $1,230.27 | $1,548.82 | $3,019.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $457.09 / $831.76 / $6,918.31
| Facility | | $457.09 | $831.76 | $6,918.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,818.38 / $5,011.87 / $10,000.00
| Facility | | $2,818.38 | $5,011.87 | $10,000.00 |