- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,037.86 / $1,628.43 / $8,413.00
| Facility | | $1,037.86 | $1,628.43 | $8,413.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,834.28 / $1,834.28 / $1,861.04
| Facility | | $1,834.28 | $1,834.28 | $1,861.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $606.10 / $606.10 / $2,062.80
| Facility | | $606.10 | $606.10 | $2,062.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,037.86 / $1,457.36 / $1,939.02
| Facility | | $1,037.86 | $1,457.36 | $1,939.02 |
- 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
- $55.00 / $7,319.28 / $7,319.28
| Facility | | $55.00 | $7,319.28 | $7,319.28 |