- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $846.61 / $1,377.76 / $10,561.00
| Facility | | $846.61 | $1,377.76 | $10,561.00 |
- 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 / $5,006.99
| Facility | | $530.04 | $530.04 | $5,006.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $846.61 / $1,096.47 / $1,750.17
| Facility | | $846.61 | $1,096.47 | $1,750.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,183.00 / $12,216.00 / $19,066.00
| Facility | | $3,183.00 | $12,216.00 | $19,066.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,793.64 / $16,394.00 / $16,547.20
| Facility | | $4,793.64 | $16,394.00 | $16,547.20 |