- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $389.05 / $389.05 / $15,488.17
| Facility | | $389.05 | $389.05 | $15,488.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,709.64 / $19,498.45 / $45,708.82
| Facility | | $8,709.64 | $19,498.45 | $45,708.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $912.01 / $1,288.25 / $3,090.30
| Facility | | $912.01 | $1,288.25 | $3,090.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $977.24 / $1,230.27 / $2,398.83
| Facility | | $977.24 | $1,230.27 | $2,398.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.03 / $954.99 / $12,302.69
| Facility | | $537.03 | $954.99 | $12,302.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,888.44 / $10,000.00 / $20,892.96
| Facility | | $5,888.44 | $10,000.00 | $20,892.96 |