- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $340.19 / $1,338.00 / $8,413.00
| Facility | | $340.19 | $1,338.00 | $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 / $1,438.74
| Facility | | $606.10 | $606.10 | $1,438.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $340.19 / $472.86 / $768.83
| Facility | | $340.19 | $472.86 | $768.83 |
- 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
- $1,319.68 / $4,754.80 / $26,542.00
| Facility | | $1,319.68 | $4,754.80 | $26,542.00 |