- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $578.78 / $578.78 / $3,638.00
| Facility | | $578.78 | $578.78 | $3,638.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,696.09 / $11,540.50 / $22,684.35
| Facility | | $6,696.09 | $11,540.50 | $22,684.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,470.59 / $2,085.48 / $5,016.91
| Facility | | $1,470.59 | $2,085.48 | $5,016.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,195.49 / $1,906.63 / $3,950.33
| Facility | | $1,195.49 | $1,906.63 | $3,950.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $798.56 / $1,221.86 / $9,255.00
| Facility | | $798.56 | $1,221.86 | $9,255.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,293.00 / $6,652.00 / $9,810.00
| Facility | | $3,293.00 | $6,652.00 | $9,810.00 |