- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $587.17 / $587.17 / $7,397.00
| Facility | | $587.17 | $587.17 | $7,397.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,218.14 / $11,925.72 / $26,540.37
| Facility | | $4,218.14 | $11,925.72 | $26,540.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,304.67 / $1,850.18 / $4,450.85
| Facility | | $1,304.67 | $1,850.18 | $4,450.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,060.59 / $1,691.51 / $3,504.61
| Facility | | $1,060.59 | $1,691.51 | $3,504.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $838.09 / $1,206.82 / $12,367.00
| Facility | | $838.09 | $1,206.82 | $12,367.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,913.00 / $12,722.00 / $25,103.91
| Facility | | $5,913.00 | $12,722.00 | $25,103.91 |