- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $500.04 / $665.79 / $4,557.00
| Facility | | $500.04 | $665.79 | $4,557.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,297.10 / $5,939.08 / $11,503.06
| Facility | | $2,297.10 | $5,939.08 | $11,503.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,622.21 / $2,301.67 / $5,536.99
| Facility | | $1,622.21 | $2,301.67 | $5,536.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.73 / $2,104.28 / $4,359.84
| Facility | | $1,474.73 | $2,104.28 | $4,359.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $465.15 / $1,006.26 / $1,800.78
| Facility | | $465.15 | $1,006.26 | $1,800.78 |
- 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 |