- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $584.32 / $584.32 / $3,119.00
| Facility | | $584.32 | $584.32 | $3,119.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,802.72 / $17,652.15 / $35,715.98
| Facility | | $7,802.72 | $17,652.15 | $35,715.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,484.07 / $2,104.59 / $5,062.89
| Facility | | $1,484.07 | $2,104.59 | $5,062.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,206.44 / $1,924.10 / $3,986.53
| Facility | | $1,206.44 | $1,924.10 | $3,986.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $804.80 / $1,235.83 / $9,255.00
| Facility | | $804.80 | $1,235.83 | $9,255.00 |
- 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 |