- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,513.56 / $2,884.03 / $5,623.41
| Facility | | $1,513.56 | $2,884.03 | $5,623.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $891.25 / $3,981.07 / $28,840.32
| Facility | | $891.25 | $3,981.07 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $588.84 / $645.65 / $3,090.30
| Facility | | $588.84 | $645.65 | $3,090.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.74 / $1,000.00 / $7,079.46
| Facility | | $467.74 | $1,000.00 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.81 / $3,801.89 / $9,772.37
| Facility | | $524.81 | $3,801.89 | $9,772.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,801.89 / $3,801.89 / $3,801.89
| Facility | | $3,801.89 | $3,801.89 | $3,801.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $891.25 / $3,981.07 / $28,840.32
| Facility | | $891.25 | $3,981.07 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,071.52 / $3,890.45 / $9,549.93
| Facility | | $1,071.52 | $3,890.45 | $9,549.93 |