- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $297.56 / $297.56 / $4,828.00
| Facility | | $297.56 | $297.56 | $4,828.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,193.12 / $17,550.78 / $36,581.76
| Facility | | $7,193.12 | $17,550.78 | $36,581.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $691.50 / $980.63 / $2,359.04
| Facility | | $691.50 | $980.63 | $2,359.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $562.14 / $896.53 / $1,857.51
| Facility | | $562.14 | $896.53 | $1,857.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $434.68 / $574.50 / $10,878.00
| Facility | | $434.68 | $574.50 | $10,878.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,940.00 / $8,689.00 / $11,531.00
| Facility | | $3,940.00 | $8,689.00 | $11,531.00 |