- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $925.82 / $925.82 / $25,876.10
| Facility | | $925.82 | $925.82 | $25,876.10 |
- 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
- $2,349.92 / $3,332.47 / $8,016.72
| Facility | | $2,349.92 | $3,332.47 | $8,016.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,910.31 / $3,046.68 / $6,312.38
| Facility | | $1,910.31 | $3,046.68 | $6,312.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,312.65 / $1,953.53 / $9,404.00
| Facility | | $1,312.65 | $1,953.53 | $9,404.00 |
- 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 |