- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $596.69 / $1,615.00 / $10,924.00
| Facility | | $596.69 | $1,615.00 | $10,924.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,993.10 / $2,192.40 / $3,720.44
| Facility | | $1,993.10 | $2,192.40 | $3,720.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $689.98 / $1,958.30 / $3,266.42
| Facility | | $689.98 | $1,958.30 | $3,266.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $596.69 / $725.87 / $1,078.40
| Facility | | $596.69 | $725.87 | $1,078.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $902.00 / $3,366.00 / $11,964.00
| Facility | | $902.00 | $3,366.00 | $11,964.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,842.35 / $9,558.29 / $26,542.00
| Facility | | $2,842.35 | $9,558.29 | $26,542.00 |