- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $800.04 / $800.04 / $7,397.00
| Facility | | $800.04 | $800.04 | $7,397.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,428.13 / $6,102.01 / $12,174.10
| Facility | | $3,428.13 | $6,102.01 | $12,174.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,986.90 / $2,817.67 / $6,778.29
| Facility | | $1,986.90 | $2,817.67 | $6,778.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,615.21 / $2,576.03 / $5,337.24
| Facility | | $1,615.21 | $2,576.03 | $5,337.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,049.50 / $1,627.87 / $7,770.00
| Facility | | $1,049.50 | $1,627.87 | $7,770.00 |
- 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 |