- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $704.09 / $4,147.85 / $6,781.00
| Facility | | $704.09 | $4,147.85 | $6,781.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,267.46 / $8,480.52 / $17,676.25
| Facility | | $3,267.46 | $8,480.52 | $17,676.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,867.30 / $2,648.06 / $6,370.27
| Facility | | $1,867.30 | $2,648.06 | $6,370.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,517.98 / $2,420.96 / $5,015.96
| Facility | | $1,517.98 | $2,420.96 | $5,015.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $743.05 / $1,540.45 / $9,233.00
| Facility | | $743.05 | $1,540.45 | $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 |