- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $197.96 / $859.34 / $4,828.00
| Facility | | $197.96 | $859.34 | $4,828.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $932.36 / $10,766.58 / $24,323.22
| Facility | | $932.36 | $10,766.58 | $24,323.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,987.74 / $2,818.87 / $6,781.17
| Facility | | $1,987.74 | $2,818.87 | $6,781.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,615.89 / $2,577.12 / $5,339.50
| Facility | | $1,615.89 | $2,577.12 | $5,339.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $326.52 / $1,077.60 / $6,652.00
| Facility | | $326.52 | $1,077.60 | $6,652.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,293.00 / $6,652.00 / $9,810.00
| Facility | | $3,293.00 | $6,652.00 | $9,810.00 |