- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $770.34 / $770.34 / $6,781.00
| Facility | | $770.34 | $770.34 | $6,781.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,317.03 / $8,221.73 / $18,574.04
| Facility | | $2,317.03 | $8,221.73 | $18,574.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,795.62 / $2,547.73 / $6,128.91
| Facility | | $1,795.62 | $2,547.73 | $6,128.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,460.47 / $2,329.23 / $4,825.91
| Facility | | $1,460.47 | $2,329.23 | $4,825.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $825.29 / $1,478.64 / $10,533.00
| Facility | | $825.29 | $1,478.64 | $10,533.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,940.00 / $8,689.00 / $11,531.00
| Facility | | $3,940.00 | $8,689.00 | $11,531.00 |