- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $404.15 / $596.00 / $3,964.69
| Facility | | $404.15 | $596.00 | $3,964.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,839.15 / $3,542.66 / $7,138.18
| Facility | | $1,839.15 | $3,542.66 | $7,138.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,005.15 / $1,426.16 / $3,430.81
| Facility | | $1,005.15 | $1,426.16 | $3,430.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $913.77 / $1,303.84 / $2,701.43
| Facility | | $913.77 | $1,303.84 | $2,701.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $449.03 / $722.35 / $3,158.28
| Facility | | $449.03 | $722.35 | $3,158.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,412.00 / $3,756.00 / $8,193.00
| Facility | | $2,412.00 | $3,756.00 | $8,193.00 |