- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $436.41 / $436.41 / $11,009.00
| Facility | | $436.41 | $436.41 | $11,009.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,048.48 / $9,238.04 / $20,312.33
| Facility | | $2,048.48 | $9,238.04 | $20,312.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $961.02 / $1,362.85 / $3,278.52
| Facility | | $961.02 | $1,362.85 | $3,278.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $781.24 / $1,245.97 / $2,581.51
| Facility | | $781.24 | $1,245.97 | $2,581.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $684.07 / $795.01 / $3,500.00
| Facility | | $684.07 | $795.01 | $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 |