- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $530.71 / $530.71 / $3,638.00
| Facility | | $530.71 | $530.71 | $3,638.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,427.07 / $9,232.28 / $20,505.30
| Facility | | $2,427.07 | $9,232.28 | $20,505.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,263.40 / $1,791.65 / $4,310.06
| Facility | | $1,263.40 | $1,791.65 | $4,310.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,027.05 / $1,638.00 / $3,393.75
| Facility | | $1,027.05 | $1,638.00 | $3,393.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $581.90 / $974.56 / $12,002.00
| Facility | | $581.90 | $974.56 | $12,002.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,577.00 / $10,743.00 / $12,774.00
| Facility | | $5,577.00 | $10,743.00 | $12,774.00 |