- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,408.85 / $4,163.57 / $8,434.00
| Facility | | $1,408.85 | $4,163.57 | $8,434.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,274.64 / $3,344.17 / $5,927.24
| Facility | | $1,274.64 | $3,344.17 | $5,927.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $177.43 / $375.00 / $1,370.63
| Facility | | $177.43 | $375.00 | $1,370.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $168.25 / $208.00 / $334.00
| Facility | | $168.25 | $208.00 | $334.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $262.23 / $314.79 / $501.00
| Facility | 50 | $262.23 | $314.79 | $501.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $729.00 / $6,607.00 / $8,667.00
| Facility | | $729.00 | $6,607.00 | $8,667.00 |