- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $588.60 / $588.60 / $9,768.00
| Facility | | $588.60 | $588.60 | $9,768.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,023.26 / $9,837.79 / $20,505.30
| Facility | | $3,023.26 | $9,837.79 | $20,505.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,375.24 / $2,146.40 / $5,163.45
| Facility | | $1,375.24 | $2,146.40 | $5,163.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,191.77 / $1,958.73 / $4,065.71
| Facility | | $1,191.77 | $1,958.73 | $4,065.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $632.69 / $1,082.35 / $2,004.93
| Facility | | $632.69 | $1,082.35 | $2,004.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,437.00 / $9,370.00 / $12,774.00
| Facility | | $3,437.00 | $9,370.00 | $12,774.00 |