- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.47 / $1,245.00 / $8,413.00
| Facility | | $467.47 | $1,245.00 | $8,413.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,703.55 / $1,703.55 / $1,728.40
| Facility | | $1,703.55 | $1,703.55 | $1,728.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $606.10 / $606.10 / $2,710.28
| Facility | | $606.10 | $606.10 | $2,710.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.47 / $605.38 / $933.56
| Facility | | $467.47 | $605.38 | $933.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,711.00 / $7,162.00 / $10,397.00
| Facility | | $1,711.00 | $7,162.00 | $10,397.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,675.46 / $8,957.00 / $26,542.00
| Facility | | $2,675.46 | $8,957.00 | $26,542.00 |