- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $479.79 / $3,219.33 / $8,413.00
| Facility | | $479.79 | $3,219.33 | $8,413.00 |
- 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
- $317.17 / $444.04 / $657.55
| Facility | | $317.17 | $444.04 | $657.55 |
- 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
- $1,243.76 / $4,754.80 / $26,542.00
| Facility | | $1,243.76 | $4,754.80 | $26,542.00 |