- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.47 / $446.47 / $6,781.00
| Facility | | $446.47 | $446.47 | $6,781.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,114.29 / $6,467.00 / $11,503.06
| Facility | | $2,114.29 | $6,467.00 | $11,503.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,090.17 / $1,546.79 / $3,721.02
| Facility | | $1,090.17 | $1,546.79 | $3,721.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $991.06 / $1,414.14 / $2,929.94
| Facility | | $991.06 | $1,414.14 | $2,929.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $447.14 / $769.52 / $4,273.00
| Facility | | $447.14 | $769.52 | $4,273.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,940.00 / $7,872.00 / $11,531.00
| Facility | | $3,940.00 | $7,872.00 | $11,531.00 |