- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $263.03 / $263.03 / $2,454.71
| Facility | | $263.03 | $263.03 | $2,454.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $6,606.93 / $15,848.93
| Facility | | $660.69 | $6,606.93 | $15,848.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $707.95 / $1,000.00 / $2,344.23
| Facility | | $707.95 | $1,000.00 | $2,344.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $758.58 / $954.99 / $1,862.09
| Facility | | $758.58 | $954.99 | $1,862.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $338.84 / $549.54 / $8,317.64
| Facility | | $338.84 | $549.54 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,884.03 / $5,248.07 / $9,120.11
| Facility | | $2,884.03 | $5,248.07 | $9,120.11 |