- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $434.96 / $614.22 / $4,557.00
| Facility | | $434.96 | $614.22 | $4,557.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,027.72 / $11,716.49 / $25,424.06
| Facility | | $2,027.72 | $11,716.49 | $25,424.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,489.20 / $2,112.96 / $5,083.00
| Facility | | $1,489.20 | $2,112.96 | $5,083.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,353.82 / $1,931.75 / $4,002.36
| Facility | | $1,353.82 | $1,931.75 | $4,002.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $563.33 / $889.28 / $1,671.59
| Facility | | $563.33 | $889.28 | $1,671.59 |
- 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 |