- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $456.60 / $2,704.85 / $5,011.00
| Facility | | $456.60 | $2,704.85 | $5,011.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,102.58 / $3,728.00 / $26,542.00
| Facility | | $1,102.58 | $3,728.00 | $26,542.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $546.10 / $701.74 / $1,251.66
| Facility | | $546.10 | $701.74 | $1,251.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $837.00 / $920.70 / $6,493.89
| Facility | | $837.00 | $920.70 | $6,493.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $460.50 / $995.76 / $6,679.00
| Facility | | $460.50 | $995.76 | $6,679.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,591.00 / $4,006.00 / $26,542.00
| Facility | | $1,591.00 | $4,006.00 | $26,542.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,591.00 / $4,006.00 / $10,764.00
| Facility | | $1,591.00 | $4,006.00 | $10,764.00 |