- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $983.97 / $1,670.72 / $15,291.00
| Facility | | $983.97 | $1,670.72 | $15,291.00 |
- 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
- $1,182.48 / $1,182.48 / $7,092.24
| Facility | | $1,182.48 | $1,182.48 | $7,092.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $983.97 / $1,299.28 / $2,046.61
| Facility | | $983.97 | $1,299.28 | $2,046.61 |
- 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
- $5,552.58 / $23,438.60 / $26,542.00
| Facility | | $5,552.58 | $23,438.60 | $26,542.00 |