- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $571.41 / $1,197.97 / $8,024.17
| Facility | | $571.41 | $1,197.97 | $8,024.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,704.83 / $1,704.83 / $1,729.70
| Facility | | $1,704.83 | $1,704.83 | $1,729.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $606.10 / $606.10 / $2,710.28
| Facility | | $606.10 | $606.10 | $2,710.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $571.41 / $827.44 / $1,348.53
| Facility | | $571.41 | $827.44 | $1,348.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,661.00 / $7,659.00 / $10,502.00
| Facility | | $1,661.00 | $7,659.00 | $10,502.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,420.32 / $2,637.44 / $26,542.00
| Facility | | $2,420.32 | $2,637.44 | $26,542.00 |