- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $515.66 / $515.66 / $6,781.00
| Facility | | $515.66 | $515.66 | $6,781.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,573.77 / $9,458.16 / $20,811.61
| Facility | | $2,573.77 | $9,458.16 | $20,811.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,202.29 / $1,876.46 / $4,514.07
| Facility | | $1,202.29 | $1,876.46 | $4,514.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,041.89 / $1,712.39 / $3,554.39
| Facility | | $1,041.89 | $1,712.39 | $3,554.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $533.98 / $939.65 / $2,960.00
| Facility | | $533.98 | $939.65 | $2,960.00 |
- 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 |