- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $306.41 / $306.41 / $2,525.00
| Facility | | $306.41 | $306.41 | $2,525.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,463.54 / $30,003.09 / $63,379.48
| Facility | | $1,463.54 | $30,003.09 | $63,379.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $742.49 / $1,053.49 / $2,534.32
| Facility | | $742.49 | $1,053.49 | $2,534.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $674.99 / $963.14 / $1,995.53
| Facility | | $674.99 | $963.14 | $1,995.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $297.88 / $527.35 / $4,273.00
| Facility | | $297.88 | $527.35 | $4,273.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,940.00 / $7,872.00 / $11,531.00
| Facility | | $3,940.00 | $7,872.00 | $11,531.00 |