- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $332.82 / $439.33 / $4,557.00
| Facility | | $332.82 | $439.33 | $4,557.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,597.40 / $9,212.18 / $20,811.61
| Facility | | $1,597.40 | $9,212.18 | $20,811.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.97 / $1,598.15 / $3,844.58
| Facility | | $1,023.97 | $1,598.15 | $3,844.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $887.36 / $1,409.05 / $3,027.23
| Facility | | $887.36 | $1,409.05 | $3,027.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $413.23 / $710.75 / $1,294.10
| Facility | | $413.23 | $710.75 | $1,294.10 |
- 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 |