- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $546.02 / $1,524.00 / $3,919.84
| Facility | | $546.02 | $1,524.00 | $3,919.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,346.61 / $3,168.23 / $6,878.09
| Facility | | $1,346.61 | $3,168.23 | $6,878.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $336.29 / $3,079.67 / $3,079.67
| Facility | | $336.29 | $3,079.67 | $3,079.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $440.62 / $650.00 / $5,955.22
| Facility | | $440.62 | $650.00 | $5,955.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $746.00 / $2,415.00 / $6,661.00
| Facility | | $746.00 | $2,415.00 | $6,661.00 |