- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $785.85 / $1,116.82 / $8,229.00
| Facility | | $785.85 | $1,116.82 | $8,229.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,642.27 / $8,584.00 / $14,014.53
| Facility | | $4,642.27 | $8,584.00 | $14,014.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $843.80 / $1,217.22 / $1,404.14
| Facility | | $843.80 | $1,217.22 | $1,404.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,065.64 / $1,065.64 / $1,099.71
| Facility | | $1,065.64 | $1,065.64 | $1,099.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $739.00 / $3,828.00 / $8,582.00
| Facility | | $739.00 | $3,828.00 | $8,582.00 |