- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $716.01 / $1,158.09 / $8,413.00
| Facility | | $716.01 | $1,158.09 | $8,413.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,066.86 / $3,066.86 / $4,382.17
| Facility | | $3,066.86 | $3,066.86 | $4,382.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $606.10 / $606.10 / $6,025.59
| Facility | | $606.10 | $606.10 | $6,025.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $727.92 / $978.00 / $1,480.60
| Facility | | $727.92 | $978.00 | $1,480.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,183.00 / $12,216.00 / $19,066.00
| Facility | | $3,183.00 | $12,216.00 | $19,066.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,516.50 / $19,913.50 / $26,542.00
| Facility | | $3,516.50 | $19,913.50 | $26,542.00 |