- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $635.53 / $635.53 / $4,828.00
| Facility | | $635.53 | $635.53 | $4,828.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,129.06 / $11,357.76 / $23,673.40
| Facility | | $3,129.06 | $11,357.76 | $23,673.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,581.80 / $2,244.34 / $5,399.07
| Facility | | $1,581.80 | $2,244.34 | $5,399.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,438.00 / $2,051.87 / $4,251.24
| Facility | | $1,438.00 | $2,051.87 | $4,251.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $699.73 / $1,176.82 / $5,331.00
| Facility | | $699.73 | $1,176.82 | $5,331.00 |
- 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 |