- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $347.43 / $519.92 / $4,557.00
| Facility | | $347.43 | $519.92 | $4,557.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,214.76 / $13,287.64 / $25,585.41
| Facility | | $4,214.76 | $13,287.64 | $25,585.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,270.32 / $1,802.40 / $4,335.92
| Facility | | $1,270.32 | $1,802.40 | $4,335.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,154.83 / $1,647.83 / $3,414.11
| Facility | | $1,154.83 | $1,647.83 | $3,414.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $412.30 / $715.11 / $1,419.35
| Facility | | $412.30 | $715.11 | $1,419.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,412.00 / $3,756.00 / $8,193.00
| Facility | | $2,412.00 | $3,756.00 | $8,193.00 |