- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $450.71 / $450.71 / $3,073.00
| Facility | | $450.71 | $450.71 | $3,073.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,902.51 / $5,489.43 / $11,441.84
| Facility | | $1,902.51 | $5,489.43 | $11,441.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.78 / $1,485.88 / $3,574.48
| Facility | | $1,047.78 | $1,485.88 | $3,574.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $851.77 / $1,358.45 / $2,814.55
| Facility | | $851.77 | $1,358.45 | $2,814.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $567.20 / $858.28 / $7,770.00
| Facility | | $567.20 | $858.28 | $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 |