- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $320.05 / $3,855.00 / $9,405.95
| Facility | | $320.05 | $3,855.00 | $9,405.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,233.39 / $7,215.03 / $14,098.13
| Facility | | $4,233.39 | $7,215.03 | $14,098.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $859.11 / $1,218.32 / $2,930.84
| Facility | | $859.11 | $1,218.32 | $2,930.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $698.39 / $1,113.83 / $2,307.75
| Facility | | $698.39 | $1,113.83 | $2,307.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $482.56 / $715.52 / $7,770.00
| Facility | | $482.56 | $715.52 | $7,770.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,735.00 / $4,974.00 / $8,812.00
| Facility | | $2,735.00 | $4,974.00 | $8,812.00 |