- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $528.46 / $528.46 / $7,859.00
| Facility | | $528.46 | $528.46 | $7,859.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,709.06 / $9,232.28 / $20,505.30
| Facility | | $2,709.06 | $9,232.28 | $20,505.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,235.96 / $1,929.01 / $4,640.50
| Facility | | $1,235.96 | $1,929.01 | $4,640.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,071.07 / $1,760.35 / $3,653.94
| Facility | | $1,071.07 | $1,760.35 | $3,653.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $566.25 / $974.43 / $1,785.70
| Facility | | $566.25 | $974.43 | $1,785.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,437.00 / $9,370.00 / $12,774.00
| Facility | | $3,437.00 | $9,370.00 | $12,774.00 |