- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $674.58 / $674.58 / $8,310.78
| Facility | | $674.58 | $674.58 | $8,310.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,056.92 / $5,939.08 / $11,966.76
| Facility | | $3,056.92 | $5,939.08 | $11,966.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,646.62 / $2,336.31 / $5,620.32
| Facility | | $1,646.62 | $2,336.31 | $5,620.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,496.93 / $2,135.94 / $4,425.45
| Facility | | $1,496.93 | $2,135.94 | $4,425.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $704.63 / $1,377.23 / $6,740.00
| Facility | | $704.63 | $1,377.23 | $6,740.00 |
- 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 |