- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $915.24 / $2,897.00 / $7,562.14
| Facility | | $915.24 | $2,897.00 | $7,562.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $552.79 / $2,064.02 / $3,616.69
| Facility | | $552.79 | $2,064.02 | $3,616.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.00 / $3,280.17 / $5,374.52
| Facility | | $446.00 | $3,280.17 | $5,374.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $368.76 / $487.16 / $1,017.45
| Facility | | $368.76 | $487.16 | $1,017.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $845.00 / $3,311.00 / $5,133.00
| Facility | | $845.00 | $3,311.00 | $5,133.00 |