- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $411.55 / $1,473.20 / $3,363.00
| Facility | | $411.55 | $1,473.20 | $3,363.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $935.17 / $2,946.84 / $12,000.00
| Facility | | $935.17 | $2,946.84 | $12,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $511.22 / $656.92 / $1,171.72
| Facility | | $511.22 | $656.92 | $1,171.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $443.00 / $500.00 / $3,111.82
| Facility | | $443.00 | $500.00 | $3,111.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $377.00 / $932.16 / $6,679.00
| Facility | | $377.00 | $932.16 | $6,679.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $663.04 / $1,928.58 / $4,680.21
| Facility | | $663.04 | $1,928.58 | $4,680.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,061.00 / $2,946.84 / $12,000.00
| Facility | | $1,061.00 | $2,946.84 | $12,000.00 |
- 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 |