- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $561.54 / $2,295.13 / $7,898.60
| Facility | | $561.54 | $2,295.13 | $7,898.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $395.75 / $395.75 / $3,337.02
| Facility | | $395.75 | $395.75 | $3,337.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $363.05 / $451.00 / $794.57
| Facility | | $363.05 | $451.00 | $794.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,248.00 / $9,541.00 / $14,589.00
| Facility | | $2,248.00 | $9,541.00 | $14,589.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,120.64 / $11,028.25 / $12,000.00
| Facility | | $1,120.64 | $11,028.25 | $12,000.00 |