- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $735.30 / $1,511.22 / $5,901.58
| Facility | | $735.30 | $1,511.22 | $5,901.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,494.80 / $1,644.27 / $2,790.28
| Facility | | $1,494.80 | $1,644.27 | $2,790.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $453.24 / $1,828.86 / $3,635.94
| Facility | | $453.24 | $1,828.86 | $3,635.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $355.46 / $668.98 / $985.58
| Facility | | $355.46 | $668.98 | $985.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $773.00 / $1,208.00 / $9,324.00
| Facility | | $773.00 | $1,208.00 | $9,324.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,305.31 / $10,639.60 / $16,394.00
| Facility | | $2,305.31 | $10,639.60 | $16,394.00 |