- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $407.47 / $407.47 / $4,828.00
| Facility | | $407.47 | $407.47 | $4,828.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,229.94 / $15,760.79 / $36,247.94
| Facility | | $1,229.94 | $15,760.79 | $36,247.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $942.85 / $1,471.54 / $3,540.00
| Facility | | $942.85 | $1,471.54 | $3,540.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $817.06 / $1,342.88 / $2,787.40
| Facility | | $817.06 | $1,342.88 | $2,787.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $464.81 / $745.38 / $1,356.00
| Facility | | $464.81 | $745.38 | $1,356.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,437.00 / $9,370.00 / $12,774.00
| Facility | | $3,437.00 | $9,370.00 | $12,774.00 |