- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $736.22 / $6,460.37 / $10,453.00
| Facility | | $736.22 | $6,460.37 | $10,453.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,297.06 / $2,297.06 / $2,330.58
| Facility | | $2,297.06 | $2,297.06 | $2,330.58 |
- 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
- $639.37 / $888.76 / $1,508.00
| Facility | | $639.37 | $888.76 | $1,508.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,035.29 / $8,035.29 / $8,035.29
| Facility | | $8,035.29 | $8,035.29 | $8,035.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,248.00 / $9,541.00 / $14,589.00
| Facility | | $2,248.00 | $9,541.00 | $14,589.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,075.30 / $8,957.00 / $33,500.00
| Facility | | $3,075.30 | $8,957.00 | $33,500.00 |