- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $655.47 / $655.47 / $6,781.00
| Facility | | $655.47 | $655.47 | $6,781.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,204.40 / $9,984.76 / $20,811.61
| Facility | | $3,204.40 | $9,984.76 | $20,811.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,532.13 / $2,391.26 / $5,752.50
| Facility | | $1,532.13 | $2,391.26 | $5,752.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,327.73 / $2,182.17 / $4,529.53
| Facility | | $1,327.73 | $2,182.17 | $4,529.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $680.22 / $1,198.97 / $2,087.65
| Facility | | $680.22 | $1,198.97 | $2,087.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,623.00 / $4,746.00 / $8,812.00
| Facility | | $1,623.00 | $4,746.00 | $8,812.00 |