- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $659.10 / $659.10 / $4,828.00
| Facility | | $659.10 | $659.10 | $4,828.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,181.96 / $9,745.21 / $20,312.33
| Facility | | $3,181.96 | $9,745.21 | $20,312.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,457.96 / $2,067.57 / $4,973.81
| Facility | | $1,457.96 | $2,067.57 | $4,973.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,185.22 / $1,890.25 / $3,916.39
| Facility | | $1,185.22 | $1,890.25 | $3,916.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,037.04 / $1,205.20 / $3,500.00
| Facility | | $1,037.04 | $1,205.20 | $3,500.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,751.00 / $3,500.00 / $8,152.00
| Facility | | $1,751.00 | $3,500.00 | $8,152.00 |