- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $563.41 / $3,828.38 / $10,453.00
| Facility | | $563.41 | $3,828.38 | $10,453.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,503.36 / $2,503.36 / $2,539.89
| Facility | | $2,503.36 | $2,503.36 | $2,539.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $748.70 / $748.70 / $2,710.28
| Facility | | $748.70 | $748.70 | $2,710.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $563.41 / $828.18 / $1,216.78
| Facility | | $563.41 | $828.18 | $1,216.78 |
- 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
- $2,136.40 / $8,957.00 / $26,542.00
| Facility | | $2,136.40 | $8,957.00 | $26,542.00 |