- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $244.05 / $1,426.34 / $2,168.00
| Facility | | $244.05 | $1,426.34 | $2,168.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.98 / $1,055.61 / $2,069.07
| Facility | | $0.98 | $1,055.61 | $2,069.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,937.22 / $4,584.24 / $11,028.01
| Facility | | $2,937.22 | $4,584.24 | $11,028.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,545.36 / $4,041.80 / $8,683.48
| Facility | | $2,545.36 | $4,041.80 | $8,683.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $307.36 / $1,234.52 / $3,162.11
| Facility | | $307.36 | $1,234.52 | $3,162.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $563.00 / $1,749.00 / $2,883.00
| Facility | | $563.00 | $1,749.00 | $2,883.00 |