- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $605.45 / $7,501.62 / $10,463.24
| Facility | | $605.45 | $7,501.62 | $10,463.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,863.39 / $1,863.39 / $2,662.55
| Facility | | $1,863.39 | $1,863.39 | $2,662.55 |
- 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
- $605.45 / $766.43 / $1,227.08
| Facility | | $605.45 | $766.43 | $1,227.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,470.62 / $9,447.00 / $14,257.00
| Facility | | $2,470.62 | $9,447.00 | $14,257.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,266.67 / $8,957.00 / $26,542.00
| Facility | | $2,266.67 | $8,957.00 | $26,542.00 |