- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $464.18 / $464.18 / $6,781.00
| Facility | | $464.18 | $464.18 | $6,781.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,295.48 / $7,053.26 / $12,294.94
| Facility | | $3,295.48 | $7,053.26 | $12,294.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,244.02 / $1,764.18 / $4,243.97
| Facility | | $1,244.02 | $1,764.18 | $4,243.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,011.30 / $1,612.88 / $3,341.71
| Facility | | $1,011.30 | $1,612.88 | $3,341.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $653.72 / $1,034.75 / $9,142.33
| Facility | | $653.72 | $1,034.75 | $9,142.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,256.00 / $4,760.00 / $9,787.00
| Facility | | $3,256.00 | $4,760.00 | $9,787.00 |