- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $296.02 / $473.50 / $2,525.00
| Facility | | $296.02 | $473.50 | $2,525.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,954.49 / $6,889.31 / $13,089.90
| Facility | | $3,954.49 | $6,889.31 | $13,089.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,165.93 / $1,654.29 / $3,979.62
| Facility | | $1,165.93 | $1,654.29 | $3,979.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,002.50 / $1,512.42 / $3,133.56
| Facility | | $1,002.50 | $1,512.42 | $3,133.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $378.18 / $611.57 / $1,290.27
| Facility | | $378.18 | $611.57 | $1,290.27 |
- 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 |