- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $272.38 / $2,663.12 / $4,256.81
| Facility | | $272.38 | $2,663.12 | $4,256.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $438.93 / $1,588.55 / $16,394.00
| Facility | | $438.93 | $1,588.55 | $16,394.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $208.68 / $271.27 / $517.37
| Facility | | $208.68 | $271.27 | $517.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $181.28 / $380.50 / $6,679.00
| Facility | | $181.28 | $380.50 | $6,679.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,299.61 / $3,299.61 / $3,299.61
| Facility | | $3,299.61 | $3,299.61 | $3,299.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $885.54 / $2,430.00 / $16,394.00
| Facility | | $885.54 | $2,430.00 | $16,394.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,106.00 / $2,408.00 / $5,683.00
| Facility | | $1,106.00 | $2,408.00 | $5,683.00 |