- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $351.41 / $555.91 / $2,525.00
| Facility | | $351.41 | $555.91 | $2,525.00 |
- 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
- $1,324.20 / $1,878.85 / $4,519.82
| Facility | | $1,324.20 | $1,878.85 | $4,519.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,150.76 / $1,717.72 / $3,558.91
| Facility | | $1,150.76 | $1,717.72 | $3,558.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $427.18 / $729.05 / $1,457.42
| Facility | | $427.18 | $729.05 | $1,457.42 |
- 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 |