- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $364.71 / $364.71 / $4,828.00
| Facility | | $364.71 | $364.71 | $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
- $845.63 / $1,199.21 / $2,884.87
| Facility | | $845.63 | $1,199.21 | $2,884.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $687.44 / $1,096.36 / $2,271.55
| Facility | | $687.44 | $1,096.36 | $2,271.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $532.47 / $702.99 / $11,680.00
| Facility | | $532.47 | $702.99 | $11,680.00 |
- 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 |