- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $612.50 / $1,457.74 / $7,799.00
| Facility | | $612.50 | $1,457.74 | $7,799.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,708.33 / $4,006.56 / $7,836.30
| Facility | | $1,708.33 | $4,006.56 | $7,836.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $505.00 / $780.00 / $1,370.63
| Facility | | $505.00 | $780.00 | $1,370.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $549.34 / $712.17 / $1,136.39
| Facility | | $549.34 | $712.17 | $1,136.39 |
- 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 |