- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $995.47 / $995.47 / $10,647.00
| Facility | | $995.47 | $995.47 | $10,647.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,858.68 / $10,188.53 / $21,650.55
| Facility | | $4,858.68 | $10,188.53 | $21,650.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,326.51 / $3,631.08 / $8,735.06
| Facility | | $2,326.51 | $3,631.08 | $8,735.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,016.13 / $3,313.60 / $6,878.00
| Facility | | $2,016.13 | $3,313.60 | $6,878.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,062.48 / $1,974.86 / $6,475.05
| Facility | | $1,062.48 | $1,974.86 | $6,475.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,960.00 / $7,872.00 / $11,531.00
| Facility | | $2,960.00 | $7,872.00 | $11,531.00 |