- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $155.27 / $453.37 / $2,525.00
| Facility | | $155.27 | $453.37 | $2,525.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $328.42 / $5,677.23 / $12,389.06
| Facility | | $328.42 | $5,677.23 | $12,389.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,132.84 / $1,606.52 / $3,864.69
| Facility | | $1,132.84 | $1,606.52 | $3,864.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $920.92 / $1,468.74 / $3,043.06
| Facility | | $920.92 | $1,468.74 | $3,043.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $247.24 / $759.39 / $4,746.00
| Facility | | $247.24 | $759.39 | $4,746.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,735.00 / $4,974.00 / $8,812.00
| Facility | | $2,735.00 | $4,974.00 | $8,812.00 |