- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $604.50 / $2,136.77 / $11,093.00
| Facility | | $604.50 | $2,136.77 | $11,093.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,411.35 / $7,857.00 / $18,942.00
| Facility | | $1,411.35 | $7,857.00 | $18,942.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $621.38 / $852.88 / $1,279.32
| Facility | | $621.38 | $852.88 | $1,279.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,116.34 / $2,116.34 / $2,508.71
| Facility | | $2,116.34 | $2,116.34 | $2,508.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,932.00 / $8,348.00 / $12,569.00
| Facility | | $3,932.00 | $8,348.00 | $12,569.00 |