- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $247.46 / $247.46 / $2,525.00
| Facility | | $247.46 | $247.46 | $2,525.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,686.63 / $16,037.37 / $31,408.96
| Facility | | $6,686.63 | $16,037.37 | $31,408.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $547.47 / $776.38 / $1,867.69
| Facility | | $547.47 | $776.38 | $1,867.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $445.06 / $709.80 / $1,470.63
| Facility | | $445.06 | $709.80 | $1,470.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $358.96 / $506.18 / $9,588.15
| Facility | | $358.96 | $506.18 | $9,588.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,293.00 / $6,652.00 / $9,810.00
| Facility | | $3,293.00 | $6,652.00 | $9,810.00 |