- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $601.80 / $1,200.08 / $7,278.00
| Facility | | $601.80 | $1,200.08 | $7,278.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,474.86 / $3,474.86 / $3,525.56
| Facility | | $3,474.86 | $3,474.86 | $3,525.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $530.04 / $530.04 / $2,393.27
| Facility | | $530.04 | $530.04 | $2,393.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $601.80 / $883.65 / $1,420.27
| Facility | | $601.80 | $883.65 | $1,420.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,661.00 / $7,659.00 / $10,502.00
| Facility | | $1,661.00 | $7,659.00 | $10,502.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,336.92 / $4,336.92 / $16,394.00
| Facility | | $4,336.92 | $4,336.92 | $16,394.00 |