- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $295.12 / $371.54 / $7,585.78
| Facility | | $295.12 | $371.54 | $7,585.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $741.31 / $9,772.37 / $23,442.29
| Facility | | $741.31 | $9,772.37 | $23,442.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $1,412.54 / $3,388.44
| Facility | | $1,000.00 | $1,412.54 | $3,388.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,096.48 / $1,348.96 / $2,630.27
| Facility | | $1,096.48 | $1,348.96 | $2,630.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $416.87 / $645.65 / $7,762.47
| Facility | | $416.87 | $645.65 | $7,762.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,884.03 / $5,248.07 / $13,489.63
| Facility | | $2,884.03 | $5,248.07 | $13,489.63 |