- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $563.46 / $563.46 / $3,638.00
| Facility | | $563.46 | $563.46 | $3,638.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,511.39 / $8,041.59 / $16,510.18
| Facility | | $4,511.39 | $8,041.59 | $16,510.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,510.18 / $2,141.62 / $5,151.96
| Facility | | $1,510.18 | $2,141.62 | $5,151.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,227.67 / $1,957.96 / $4,056.66
| Facility | | $1,227.67 | $1,957.96 | $4,056.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $830.64 / $1,256.52 / $9,793.00
| Facility | | $830.64 | $1,256.52 | $9,793.00 |
- 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 |