- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $344.78 / $2,006.25 / $4,535.00
| Facility | | $344.78 | $2,006.25 | $4,535.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.98 / $1,452.04 / $2,846.07
| Facility | | $0.98 | $1,452.04 | $2,846.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,322.50 / $6,129.84 / $14,746.16
| Facility | | $4,322.50 | $6,129.84 | $14,746.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,403.54 / $5,604.14 / $11,611.15
| Facility | | $3,403.54 | $5,604.14 | $11,611.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $543.04 / $1,052.39 / $3,888.19
| Facility | | $543.04 | $1,052.39 | $3,888.19 |
- 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 |