- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $181.29 / $706.50 / $2,433.00
| Facility | | $181.29 | $706.50 | $2,433.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $940.51 / $6,024.48 / $13,610.15
| Facility | | $940.51 | $6,024.48 | $13,610.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,515.32 / $2,541.76 / $6,114.54
| Facility | | $1,515.32 | $2,541.76 | $6,114.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,307.02 / $2,241.00 / $4,814.60
| Facility | | $1,307.02 | $2,241.00 | $4,814.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $236.55 / $665.88 / $2,022.62
| Facility | | $236.55 | $665.88 | $2,022.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,623.00 / $4,746.00 / $8,812.00
| Facility | | $1,623.00 | $4,746.00 | $8,812.00 |