- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $481.81 / $481.81 / $4,828.00
| Facility | | $481.81 | $481.81 | $4,828.00 |
- 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
- $1,294.56 / $1,835.85 / $4,416.38
| Facility | | $1,294.56 | $1,835.85 | $4,416.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,052.38 / $1,678.40 / $3,477.46
| Facility | | $1,052.38 | $1,678.40 | $3,477.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $691.06 / $1,076.84 / $8,934.85
| Facility | | $691.06 | $1,076.84 | $8,934.85 |
- 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 |