- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $572.46 / $572.46 / $22,737.76
| Facility | | $572.46 | $572.46 | $22,737.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,552.58 / $11,823.30 / $25,424.06
| Facility | | $2,552.58 | $11,823.30 | $25,424.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,403.33 / $1,991.12 / $4,789.92
| Facility | | $1,403.33 | $1,991.12 | $4,789.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,275.76 / $1,820.36 / $3,771.59
| Facility | | $1,275.76 | $1,820.36 | $3,771.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $572.46 / $1,070.51 / $7,645.00
| Facility | | $572.46 | $1,070.51 | $7,645.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,457.00 / $9,370.00 / $12,774.00
| Facility | | $5,457.00 | $9,370.00 | $12,774.00 |