- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $1,000.00 / $7,762.47
| Facility | | $660.69 | $1,000.00 | $7,762.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,398.83 / $8,709.64 / $13,489.63
| Facility | | $2,398.83 | $8,709.64 | $13,489.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.44 / $724.44 / $1,659.59
| Facility | | $724.44 | $724.44 | $1,659.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $371.54 / $588.84 / $1,023.29
| Facility | | $371.54 | $588.84 | $1,023.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $645.65 / $6,025.60 / $12,022.64
| Facility | | $645.65 | $6,025.60 | $12,022.64 |