- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $438.68 / $557.59 / $6,205.00
| Facility | | $438.68 | $557.59 | $6,205.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,117.37 / $9,458.16 / $20,811.61
| Facility | | $2,117.37 | $9,458.16 | $20,811.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,304.83 / $2,036.51 / $4,899.10
| Facility | | $1,304.83 | $2,036.51 | $4,899.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,130.76 / $1,795.54 / $3,857.56
| Facility | | $1,130.76 | $1,795.54 | $3,857.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $529.37 / $933.57 / $1,647.48
| Facility | | $529.37 | $933.57 | $1,647.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,960.00 / $7,872.00 / $11,531.00
| Facility | | $2,960.00 | $7,872.00 | $11,531.00 |