- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $490.42 / $1,615.00 / $15,291.00
| Facility | | $490.42 | $1,615.00 | $15,291.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,326.31 / $1,326.31 / $1,345.66
| Facility | | $1,326.31 | $1,326.31 | $1,345.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,182.48 / $1,182.48 / $2,710.28
| Facility | | $1,182.48 | $1,182.48 | $2,710.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $490.42 / $602.50 / $1,087.00
| Facility | | $490.42 | $602.50 | $1,087.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $900.00 / $3,733.00 / $6,543.00
| Facility | | $900.00 | $3,733.00 | $6,543.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,899.04 / $8,957.00 / $26,542.00
| Facility | | $1,899.04 | $8,957.00 | $26,542.00 |