- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $326.66 / $798.30 / $7,968.00
| Facility | | $326.66 | $798.30 | $7,968.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,426.56 / $1,426.56 / $2,038.38
| Facility | | $1,426.56 | $1,426.56 | $2,038.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $748.70 / $748.70 / $6,025.59
| Facility | | $748.70 | $748.70 | $6,025.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $327.52 / $590.27 / $861.08
| Facility | | $327.52 | $590.27 | $861.08 |
- 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
- $1,565.12 / $1,728.86 / $26,542.00
| Facility | | $1,565.12 | $1,728.86 | $26,542.00 |