- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $691.83 / $691.83 / $7,079.46
| Facility | | $691.83 | $691.83 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,466.84 / $10,715.19 / $22,387.21
| Facility | | $4,466.84 | $10,715.19 | $22,387.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,949.84 / $2,754.23 / $6,456.54
| Facility | | $1,949.84 | $2,754.23 | $6,456.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,089.30 / $2,630.27 / $5,128.61
| Facility | | $2,089.30 | $2,630.27 | $5,128.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $933.25 / $1,513.56 / $10,000.00
| Facility | | $933.25 | $1,513.56 | $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 |