- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $65.84 / $360.02 / $2,977.00
| Facility | | $65.84 | $360.02 | $2,977.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,206.67 / $7,465.39 / $14,249.16
| Facility | | $4,206.67 | $7,465.39 | $14,249.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,349.45 / $1,914.68 / $4,606.02
| Facility | | $1,349.45 | $1,914.68 | $4,606.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,215.77 / $1,750.48 / $3,626.79
| Facility | | $1,215.77 | $1,750.48 | $3,626.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $430.64 / $750.18 / $1,624.08
| Facility | | $430.64 | $750.18 | $1,624.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,412.00 / $7,770.00 / $10,734.22
| Facility | | $2,412.00 | $7,770.00 | $10,734.22 |