- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $741.31 / $3,090.30 / $5,623.41
| Facility | | $741.31 | $3,090.30 | $5,623.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $1,819.70 / $7,079.46
| Facility | | $56.23 | $1,819.70 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.12 / $741.31 / $1,380.38
| Facility | | $50.12 | $741.31 | $1,380.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $302.00 / $1,230.27 / $8,511.38
| Facility | | $302.00 | $1,230.27 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $295.12 / $2,454.71 / $4,677.35
| Facility | | $295.12 | $2,454.71 | $4,677.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $1,819.70 / $7,079.46
| Facility | | $56.23 | $1,819.70 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $794.33 / $2,754.23 / $4,677.35
| Facility | | $794.33 | $2,754.23 | $4,677.35 |