- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $651.90 / $1,192.00 / $6,757.01
| Facility | | $651.90 | $1,192.00 | $6,757.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,060.13 / $5,939.08 / $11,966.76
| Facility | | $3,060.13 | $5,939.08 | $11,966.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,587.69 / $2,252.69 / $5,419.19
| Facility | | $1,587.69 | $2,252.69 | $5,419.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,443.36 / $2,059.51 / $4,267.08
| Facility | | $1,443.36 | $2,059.51 | $4,267.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $712.87 / $1,122.93 / $3,797.54
| Facility | | $712.87 | $1,122.93 | $3,797.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,121.00 / $5,499.00 / $9,810.00
| Facility | | $3,121.00 | $5,499.00 | $9,810.00 |