- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $192.98 / $835.75 / $2,525.00
| Facility | | $192.98 | $835.75 | $2,525.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $507.41 / $5,898.73 / $12,294.94
| Facility | | $507.41 | $5,898.73 | $12,294.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,775.24 / $2,977.73 / $7,163.32
| Facility | | $1,775.24 | $2,977.73 | $7,163.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,653.36 / $2,625.38 / $5,640.41
| Facility | | $1,653.36 | $2,625.38 | $5,640.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $258.86 / $801.63 / $2,115.67
| Facility | | $258.86 | $801.63 | $2,115.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,293.00 / $6,652.00 / $9,810.00
| Facility | | $3,293.00 | $6,652.00 | $9,810.00 |