- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $338.06 / $518.03 / $7,330.60
| Facility | | $338.06 | $518.03 | $7,330.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,214.76 / $13,287.64 / $25,585.41
| Facility | | $4,214.76 | $13,287.64 | $25,585.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,262.75 / $1,791.65 / $4,310.06
| Facility | | $1,262.75 | $1,791.65 | $4,310.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,140.50 / $1,638.00 / $3,393.75
| Facility | | $1,140.50 | $1,638.00 | $3,393.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $421.60 / $695.78 / $1,458.24
| Facility | | $421.60 | $695.78 | $1,458.24 |
- 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 |