- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,965.00 / $6,060.00 / $10,695.00
| Facility | | $1,965.00 | $6,060.00 | $10,695.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $552.79 / $2,064.02 / $3,616.69
| Facility | | $552.79 | $2,064.02 | $3,616.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,084.18 / $8,045.44 / $13,182.38
| Facility | | $6,084.18 | $8,045.44 | $13,182.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $441.73 / $5,175.35 / $10,147.49
| Facility | | $441.73 | $5,175.35 | $10,147.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,472.00 / $7,088.00 / $11,396.00
| Facility | | $1,472.00 | $7,088.00 | $11,396.00 |