- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $534.91 / $2,074.00 / $7,278.00
| Facility | | $534.91 | $2,074.00 | $7,278.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,686.35 / $1,686.35 / $2,409.59
| Facility | | $1,686.35 | $1,686.35 | $2,409.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $530.04 / $530.04 / $2,710.28
| Facility | | $530.04 | $530.04 | $2,710.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $490.31 / $615.15 / $978.87
| Facility | | $490.31 | $615.15 | $978.87 |
- 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
- $2,086.32 / $8,957.00 / $16,394.00
| Facility | | $2,086.32 | $8,957.00 | $16,394.00 |