- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $250.42 / $1,137.54 / $4,828.00
| Facility | | $250.42 | $1,137.54 | $4,828.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,320.71 / $7,047.13 / $12,389.06
| Facility | | $3,320.71 | $7,047.13 | $12,389.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,791.26 / $3,958.36 / $9,522.36
| Facility | | $2,791.26 | $3,958.36 | $9,522.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,269.10 / $3,618.89 / $7,497.93
| Facility | | $2,269.10 | $3,618.89 | $7,497.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $400.13 / $1,799.01 / $7,412.96
| Facility | | $400.13 | $1,799.01 | $7,412.96 |
- 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 |