- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $864.48 / $864.48 / $6,781.00
| Facility | | $864.48 | $864.48 | $6,781.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,334.17 / $15,760.79 / $36,247.94
| Facility | | $4,334.17 | $15,760.79 | $36,247.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,191.57 / $3,107.92 / $7,476.52
| Facility | | $2,191.57 | $3,107.92 | $7,476.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,781.59 / $2,841.38 / $5,887.03
| Facility | | $1,781.59 | $2,841.38 | $5,887.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,229.44 / $1,822.96 / $10,533.00
| Facility | | $1,229.44 | $1,822.96 | $10,533.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,940.00 / $8,689.00 / $11,531.00
| Facility | | $3,940.00 | $8,689.00 | $11,531.00 |