- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $400.27 / $542.62 / $2,168.00
| Facility | | $400.27 | $542.62 | $2,168.00 |
- 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
- $1,268.86 / $1,980.37 / $4,764.06
| Facility | | $1,268.86 | $1,980.37 | $4,764.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,099.58 / $1,746.04 / $3,751.23
| Facility | | $1,099.58 | $1,746.04 | $3,751.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $387.91 / $817.06 / $1,593.50
| Facility | | $387.91 | $817.06 | $1,593.50 |
- 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 |