- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $891.25 / $891.25 / $7,079.46
| Facility | | $891.25 | $891.25 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,754.40 / $11,481.54 / $22,387.21
| Facility | | $5,754.40 | $11,481.54 | $22,387.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,511.89 / $3,548.13 / $8,511.38
| Facility | | $2,511.89 | $3,548.13 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,754.23 / $3,388.44 / $6,606.93
| Facility | | $2,754.23 | $3,388.44 | $6,606.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,288.25 / $2,041.74 / $10,000.00
| Facility | | $1,288.25 | $2,041.74 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,311.31 / $6,456.54 / $12,589.25
| Facility | | $3,311.31 | $6,456.54 | $12,589.25 |