- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $285.66 / $2,663.12 / $4,806.64
| Facility | | $285.66 | $2,663.12 | $4,806.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $392.35 / $5,854.00 / $41,339.44
| Facility | | $392.35 | $5,854.00 | $41,339.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $341.02 / $438.21 / $782.30
| Facility | | $341.02 | $438.21 | $782.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $296.89 / $621.82 / $6,679.00
| Facility | | $296.89 | $621.82 | $6,679.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,931.75 / $3,103.34 / $45,549.38
| Facility | | $1,931.75 | $3,103.34 | $45,549.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,016.24 / $7,775.00 / $30,331.00
| Facility | | $2,016.24 | $7,775.00 | $30,331.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,594.00 / $7,775.00 / $30,331.00
| Facility | | $2,594.00 | $7,775.00 | $30,331.00 |