- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $369.41 / $5,538.76 / $6,955.00
| Facility | | $369.41 | $5,538.76 | $6,955.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,206.67 / $7,465.39 / $14,249.16
| Facility | | $4,206.67 | $7,465.39 | $14,249.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $905.81 / $1,285.21 / $3,091.75
| Facility | | $905.81 | $1,285.21 | $3,091.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $823.46 / $1,174.99 / $2,434.44
| Facility | | $823.46 | $1,174.99 | $2,434.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $369.41 / $633.46 / $3,312.00
| Facility | | $369.41 | $633.46 | $3,312.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,412.00 / $4,746.00 / $8,812.00
| Facility | | $2,412.00 | $4,746.00 | $8,812.00 |