- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $481.62 / $3,251.23 / $8,413.00
| Facility | | $481.62 | $3,251.23 | $8,413.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,226.87 / $2,226.87 / $2,259.36
| Facility | | $2,226.87 | $2,226.87 | $2,259.36 |
- 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
- $479.37 / $611.30 / $981.85
| Facility | | $479.37 | $611.30 | $981.85 |
- 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
- $1,808.28 / $8,957.00 / $26,542.00
| Facility | | $1,808.28 | $8,957.00 | $26,542.00 |