- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $314.52 / $750.08 / $8,413.00
| Facility | | $314.52 | $750.08 | $8,413.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,704.83 / $1,704.83 / $1,729.70
| Facility | | $1,704.83 | $1,704.83 | $1,729.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $606.10 / $606.10 / $2,710.28
| Facility | | $606.10 | $606.10 | $2,710.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.95 / $592.00 / $854.81
| Facility | | $323.95 | $592.00 | $854.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,661.00 / $7,659.00 / $10,502.00
| Facility | | $1,661.00 | $7,659.00 | $10,502.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,479.40 / $1,620.80 / $26,542.00
| Facility | | $1,479.40 | $1,620.80 | $26,542.00 |