- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $621.62 / $1,636.32 / $13,756.92
| Facility | | $621.62 | $1,636.32 | $13,756.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,094.75 / $2,094.75 / $2,993.14
| Facility | | $2,094.75 | $2,094.75 | $2,993.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $748.70 / $748.70 / $2,710.28
| Facility | | $748.70 | $748.70 | $2,710.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $621.62 / $871.00 / $1,595.00
| Facility | | $621.62 | $871.00 | $1,595.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,347.00 / $8,736.00 / $13,997.00
| Facility | | $3,347.00 | $8,736.00 | $13,997.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,407.76 / $8,957.00 / $26,542.00
| Facility | | $2,407.76 | $8,957.00 | $26,542.00 |