- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $557.48 / $2,838.80 / $6,781.00
| Facility | | $557.48 | $2,838.80 | $6,781.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,552.69 / $8,210.17 / $17,676.25
| Facility | | $2,552.69 | $8,210.17 | $17,676.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,480.70 / $2,099.82 / $5,051.39
| Facility | | $1,480.70 | $2,099.82 | $5,051.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,203.70 / $1,919.74 / $3,977.48
| Facility | | $1,203.70 | $1,919.74 | $3,977.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $545.51 / $1,222.58 / $9,233.00
| Facility | | $545.51 | $1,222.58 | $9,233.00 |
- 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 |