- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $461.58 / $461.58 / $10,608.28
| Facility | | $461.58 | $461.58 | $10,608.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,037.41 / $5,872.02 / $11,503.06
| Facility | | $2,037.41 | $5,872.02 | $11,503.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,128.05 / $1,600.54 / $3,850.32
| Facility | | $1,128.05 | $1,600.54 | $3,850.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,025.50 / $1,463.28 / $3,031.75
| Facility | | $1,025.50 | $1,463.28 | $3,031.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $458.60 / $788.42 / $2,735.00
| Facility | | $458.60 | $788.42 | $2,735.00 |
- 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 |