- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $526.32 / $526.32 / $6,575.00
| Facility | | $526.32 | $526.32 | $6,575.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,381.53 / $4,787.28 / $10,380.54
| Facility | | $2,381.53 | $4,787.28 | $10,380.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,234.43 / $1,926.62 / $4,634.75
| Facility | | $1,234.43 | $1,926.62 | $4,634.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,069.74 / $1,758.17 / $3,649.41
| Facility | | $1,069.74 | $1,758.17 | $3,649.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $548.47 / $952.43 / $1,720.74
| Facility | | $548.47 | $952.43 | $1,720.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,100.00 / $5,499.00 / $9,810.00
| Facility | | $2,100.00 | $5,499.00 | $9,810.00 |