- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $720.98 / $720.98 / $7,397.00
| Facility | | $720.98 | $720.98 | $7,397.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,896.62 / $5,601.46 / $11,903.07
| Facility | | $2,896.62 | $5,601.46 | $11,903.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,666.00 / $2,362.59 / $5,683.54
| Facility | | $1,666.00 | $2,362.59 | $5,683.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,354.34 / $2,159.98 / $4,475.22
| Facility | | $1,354.34 | $2,159.98 | $4,475.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $808.08 / $1,363.32 / $7,770.00
| Facility | | $808.08 | $1,363.32 | $7,770.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,735.00 / $4,974.00 / $8,812.00
| Facility | | $2,735.00 | $4,974.00 | $8,812.00 |