- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $400.04 / $544.74 / $4,557.00
| Facility | | $400.04 | $544.74 | $4,557.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,800.40 / $4,787.28 / $9,978.29
| Facility | | $1,800.40 | $4,787.28 | $9,978.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,271.16 / $1,983.96 / $4,772.68
| Facility | | $1,271.16 | $1,983.96 | $4,772.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,101.58 / $1,749.20 / $3,758.01
| Facility | | $1,101.58 | $1,749.20 | $3,758.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $429.42 / $863.46 / $1,705.73
| Facility | | $429.42 | $863.46 | $1,705.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,623.00 / $4,974.00 / $9,072.73
| Facility | | $1,623.00 | $4,974.00 | $9,072.73 |