- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $516.34 / $516.34 / $6,781.00
| Facility | | $516.34 | $516.34 | $6,781.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,369.51 / $5,330.47 / $11,558.36
| Facility | | $2,369.51 | $5,330.47 | $11,558.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,375.42 / $1,950.51 / $4,692.22
| Facility | | $1,375.42 | $1,950.51 | $4,692.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,118.11 / $1,783.24 / $3,694.66
| Facility | | $1,118.11 | $1,783.24 | $3,694.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $703.47 / $1,102.52 / $7,729.00
| Facility | | $703.47 | $1,102.52 | $7,729.00 |
- 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 |