- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $485.40 / $609.16 / $4,557.00
| Facility | | $485.40 | $609.16 | $4,557.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,109.73 / $3,717.82 / $7,153.52
| Facility | | $2,109.73 | $3,717.82 | $7,153.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,496.77 / $2,123.71 / $5,108.85
| Facility | | $1,496.77 | $2,123.71 | $5,108.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,360.70 / $1,941.58 / $4,022.73
| Facility | | $1,360.70 | $1,941.58 | $4,022.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $486.00 / $948.63 / $1,724.79
| Facility | | $486.00 | $948.63 | $1,724.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,412.00 / $4,746.00 / $8,812.00
| Facility | | $2,412.00 | $4,746.00 | $8,812.00 |