- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $522.19 / $522.19 / $3,638.00
| Facility | | $522.19 | $522.19 | $3,638.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,543.96 / $5,601.46 / $11,903.07
| Facility | | $2,543.96 | $5,601.46 | $11,903.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,348.46 / $1,912.29 / $4,600.27
| Facility | | $1,348.46 | $1,912.29 | $4,600.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,096.20 / $1,748.29 / $3,622.26
| Facility | | $1,096.20 | $1,748.29 | $3,622.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $597.75 / $935.60 / $4,974.00
| Facility | | $597.75 | $935.60 | $4,974.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,735.00 / $4,974.00 / $8,812.00
| Facility | | $2,735.00 | $4,974.00 | $8,812.00 |