- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $347.71 / $475.18 / $2,168.00
| Facility | | $347.71 | $475.18 | $2,168.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,524.05 / $5,064.68 / $11,441.84
| Facility | | $1,524.05 | $5,064.68 | $11,441.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,107.58 / $1,570.68 / $3,778.49
| Facility | | $1,107.58 | $1,570.68 | $3,778.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $900.38 / $1,435.98 / $2,975.19
| Facility | | $900.38 | $1,435.98 | $2,975.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $459.46 / $688.92 / $4,746.00
| Facility | | $459.46 | $688.92 | $4,746.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,735.00 / $4,974.00 / $8,812.00
| Facility | | $2,735.00 | $4,974.00 | $8,812.00 |