- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $517.41 / $517.41 / $4,828.00
| Facility | | $517.41 | $517.41 | $4,828.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,375.65 / $5,939.08 / $11,503.06
| Facility | | $2,375.65 | $5,939.08 | $11,503.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,260.22 / $1,788.07 / $4,301.43
| Facility | | $1,260.22 | $1,788.07 | $4,301.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,145.65 / $1,634.72 / $3,386.96
| Facility | | $1,145.65 | $1,634.72 | $3,386.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $531.40 / $904.84 / $3,293.00
| Facility | | $531.40 | $904.84 | $3,293.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,121.00 / $5,499.00 / $9,810.00
| Facility | | $3,121.00 | $5,499.00 | $9,810.00 |