- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $348.43 / $348.43 / $6,781.00
| Facility | | $348.43 | $348.43 | $6,781.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,600.66 / $10,766.58 / $24,323.22
| Facility | | $1,600.66 | $10,766.58 | $24,323.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $810.26 / $1,149.05 / $2,764.19
| Facility | | $810.26 | $1,149.05 | $2,764.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $658.68 / $1,050.50 / $2,176.53
| Facility | | $658.68 | $1,050.50 | $2,176.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $459.36 / $671.19 / $7,770.00
| Facility | | $459.36 | $671.19 | $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 |