- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $506.23 / $506.23 / $7,397.00
| Facility | | $506.23 | $506.23 | $7,397.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,295.50 / $5,939.08 / $11,503.06
| Facility | | $2,295.50 | $5,939.08 | $11,503.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,232.44 / $1,748.65 / $4,206.62
| Facility | | $1,232.44 | $1,748.65 | $4,206.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,120.40 / $1,598.69 / $3,312.30
| Facility | | $1,120.40 | $1,598.69 | $3,312.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $510.46 / $866.72 / $2,296.00
| Facility | | $510.46 | $866.72 | $2,296.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,388.00 / $3,500.00 / $6,361.00
| Facility | | $1,388.00 | $3,500.00 | $6,361.00 |