- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $512.86 / $512.86 / $5,011.87
| Facility | | $512.86 | $512.86 | $5,011.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,090.30 / $7,413.10 / $14,791.08
| Facility | | $3,090.30 | $7,413.10 | $14,791.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,348.96 / $1,905.46 / $4,466.84
| Facility | | $1,348.96 | $1,905.46 | $4,466.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,445.44 / $1,819.70 / $3,548.13
| Facility | | $1,445.44 | $1,819.70 | $3,548.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.03 / $1,023.29 / $6,918.31
| Facility | | $537.03 | $1,023.29 | $6,918.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,019.95 / $5,495.41 / $10,000.00
| Facility | | $3,019.95 | $5,495.41 | $10,000.00 |