- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $489.78 / $489.78 / $5,011.87
| Facility | | $489.78 | $489.78 | $5,011.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,090.30 / $12,302.69 / $29,512.09
| Facility | | $3,090.30 | $12,302.69 | $29,512.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,288.25 / $1,819.70 / $4,365.16
| Facility | | $1,288.25 | $1,819.70 | $4,365.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,412.54 / $1,737.80 / $3,388.44
| Facility | | $1,412.54 | $1,737.80 | $3,388.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $1,000.00 / $10,964.78
| Facility | | $501.19 | $1,000.00 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,623.41 / $9,120.11 / $22,387.21
| Facility | | $5,623.41 | $9,120.11 | $22,387.21 |