- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $843.58 / $843.58 / $7,397.00
| Facility | | $843.58 | $843.58 | $7,397.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,759.52 / $3,825.02 / $8,281.67
| Facility | | $1,759.52 | $3,825.02 | $8,281.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,963.15 / $2,785.42 / $6,700.71
| Facility | | $1,963.15 | $2,785.42 | $6,700.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,596.72 / $2,546.54 / $5,276.15
| Facility | | $1,596.72 | $2,546.54 | $5,276.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $859.22 / $1,468.45 / $5,499.18
| Facility | | $859.22 | $1,468.45 | $5,499.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,735.00 / $4,974.00 / $8,812.00
| Facility | | $2,735.00 | $4,974.00 | $8,812.00 |