- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $348.49 / $348.49 / $4,828.00
| Facility | | $348.49 | $348.49 | $4,828.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $910.56 / $6,024.48 / $13,610.15
| Facility | | $910.56 | $6,024.48 | $13,610.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $815.04 / $1,272.07 / $3,060.14
| Facility | | $815.04 | $1,272.07 | $3,060.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $706.31 / $1,160.84 / $2,409.56
| Facility | | $706.31 | $1,160.84 | $2,409.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $368.43 / $724.71 / $3,312.00
| Facility | | $368.43 | $724.71 | $3,312.00 |
- 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 |