- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $459.74 / $459.74 / $3,139.00
| Facility | | $459.74 | $459.74 | $3,139.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,078.19 / $4,787.28 / $10,380.54
| Facility | | $2,078.19 | $4,787.28 | $10,380.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,076.78 / $1,680.57 / $4,042.84
| Facility | | $1,076.78 | $1,680.57 | $4,042.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $933.12 / $1,533.63 / $3,183.34
| Facility | | $933.12 | $1,533.63 | $3,183.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $479.14 / $847.44 / $1,489.47
| Facility | | $479.14 | $847.44 | $1,489.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,224.00 / $3,500.00 / $6,361.00
| Facility | | $1,224.00 | $3,500.00 | $6,361.00 |