- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $460.00 / $2,794.88 / $8,998.52
| Facility | | $460.00 | $2,794.88 | $8,998.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,015.30 / $2,015.30 / $2,044.70
| Facility | | $2,015.30 | $2,015.30 | $2,044.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $530.04 / $530.04 / $2,710.28
| Facility | | $530.04 | $530.04 | $2,710.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $416.95 / $542.17 / $836.98
| Facility | | $416.95 | $542.17 | $836.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,661.00 / $7,659.00 / $10,502.00
| Facility | | $1,661.00 | $7,659.00 | $10,502.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,614.76 / $8,957.00 / $16,394.00
| Facility | | $1,614.76 | $8,957.00 | $16,394.00 |