- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $395.45 / $856.11 / $8,413.00
| Facility | | $395.45 | $856.11 | $8,413.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,686.35 / $1,686.35 / $2,409.59
| Facility | | $1,686.35 | $1,686.35 | $2,409.59 |
- 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
- $395.45 / $650.59 / $968.63
| Facility | | $395.45 | $650.59 | $968.63 |
- 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
- $1,874.48 / $2,077.79 / $26,542.00
| Facility | | $1,874.48 | $2,077.79 | $26,542.00 |