- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $161.72 / $244.33 / $4,598.00
| Facility | | $161.72 | $244.33 | $4,598.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,629.85 / $6,373.77 / $12,643.17
| Facility | | $3,629.85 | $6,373.77 | $12,643.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $657.81 / $932.85 / $2,244.11
| Facility | | $657.81 | $932.85 | $2,244.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $534.75 / $852.85 / $1,767.01
| Facility | | $534.75 | $852.85 | $1,767.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $271.26 / $447.45 / $4,746.00
| Facility | | $271.26 | $447.45 | $4,746.00 |
- 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 |