- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $354.81 / $354.81 / $2,630.27
| Facility | | $354.81 | $354.81 | $2,630.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,570.88 / $8,317.64 / $24,547.09
| Facility | | $4,570.88 | $8,317.64 | $24,547.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $1,412.54 / $3,388.44
| Facility | | $1,000.00 | $1,412.54 | $3,388.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,096.48 / $1,380.38 / $2,630.27
| Facility | | $1,096.48 | $1,380.38 | $2,630.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $457.09 / $794.33 / $8,317.64
| Facility | | $457.09 | $794.33 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,884.03 / $5,248.07 / $9,120.11
| Facility | | $2,884.03 | $5,248.07 | $9,120.11 |