- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $455.40 / $455.40 / $9,405.95
| Facility | | $455.40 | $455.40 | $9,405.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,034.21 / $9,076.59 / $20,505.30
| Facility | | $2,034.21 | $9,076.59 | $20,505.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,119.36 / $1,587.40 / $3,818.72
| Facility | | $1,119.36 | $1,587.40 | $3,818.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $909.97 / $1,451.27 / $3,006.86
| Facility | | $909.97 | $1,451.27 | $3,006.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $584.54 / $927.04 / $11,890.00
| Facility | | $584.54 | $927.04 | $11,890.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,577.00 / $10,743.00 / $12,774.00
| Facility | | $5,577.00 | $10,743.00 | $12,774.00 |