- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $363.08 / $363.08 / $6,165.95
| Facility | | $363.08 | $363.08 | $6,165.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,754.40 / $9,120.11 / $26,915.35
| Facility | | $5,754.40 | $9,120.11 | $26,915.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $851.14 / $1,202.26 / $2,818.38
| Facility | | $851.14 | $1,202.26 | $2,818.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $912.01 / $1,148.15 / $2,238.72
| Facility | | $912.01 | $1,148.15 | $2,238.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $1,000.00 / $9,332.54
| Facility | | $501.19 | $1,000.00 | $9,332.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $6,760.83 / $10,715.19
| Facility | | $1,584.89 | $6,760.83 | $10,715.19 |