- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $602.56 / $602.56 / $7,079.46
| Facility | | $602.56 | $602.56 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,981.07 / $11,481.54 / $26,302.68
| Facility | | $3,981.07 | $11,481.54 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $2,398.83 / $5,754.40
| Facility | | $1,698.24 | $2,398.83 | $5,754.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,862.09 / $2,344.23 / $4,570.88
| Facility | | $1,862.09 | $2,344.23 | $4,570.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $870.96 / $1,380.38 / $12,022.64
| Facility | | $870.96 | $1,380.38 | $12,022.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,888.44 / $10,000.00 / $15,135.61
| Facility | | $5,888.44 | $10,000.00 | $15,135.61 |