- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $508.26 / $565.16 / $2,525.00
| Facility | | $508.26 | $565.16 | $2,525.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,269.41 / $3,046.07 / $5,941.90
| Facility | | $1,269.41 | $3,046.07 | $5,941.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,389.86 / $1,972.01 / $4,743.93
| Facility | | $1,389.86 | $1,972.01 | $4,743.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,263.51 / $1,802.89 / $3,735.39
| Facility | | $1,263.51 | $1,802.89 | $3,735.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $508.26 / $892.01 / $1,495.18
| Facility | | $508.26 | $892.01 | $1,495.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $382.00 / $1,727.00 / $2,883.00
| Facility | | $382.00 | $1,727.00 | $2,883.00 |