- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $373.55 / $2,618.00 / $4,616.46
| Facility | | $373.55 | $2,618.00 | $4,616.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $835.12 / $2,813.24 / $16,394.00
| Facility | | $835.12 | $2,813.24 | $16,394.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $593.00 / $652.29 / $4,175.47
| Facility | | $593.00 | $652.29 | $4,175.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $352.39 / $749.72 / $6,679.00
| Facility | | $352.39 | $749.72 | $6,679.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,083.11 / $2,793.01 / $6,781.11
| Facility | | $1,083.11 | $2,793.01 | $6,781.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,061.00 / $4,249.00 / $16,394.00
| Facility | | $1,061.00 | $4,249.00 | $16,394.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,061.00 / $2,854.00 / $5,714.00
| Facility | | $1,061.00 | $2,854.00 | $5,714.00 |