- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $222.57 / $350.73 / $4,376.00
| Facility | | $222.57 | $350.73 | $4,376.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,866.81 / $1,866.81 / $1,929.04
| Facility | | $1,866.81 | $1,866.81 | $1,929.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $257.89 / $395.75 / $3,266.42
| Facility | | $257.89 | $395.75 | $3,266.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $222.57 / $473.77 / $567.38
| Facility | | $222.57 | $473.77 | $567.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $902.00 / $1,393.00 / $11,644.00
| Facility | | $902.00 | $1,393.00 | $11,644.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,465.03 / $9,558.29 / $12,000.00
| Facility | | $1,465.03 | $9,558.29 | $12,000.00 |