- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $671.86 / $1,245.00 / $8,413.00
| Facility | | $671.86 | $1,245.00 | $8,413.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,206.13 / $3,206.13 / $3,252.91
| Facility | | $3,206.13 | $3,206.13 | $3,252.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $606.10 / $606.10 / $7,381.12
| Facility | | $606.10 | $606.10 | $7,381.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $671.86 / $782.94 / $1,237.75
| Facility | | $671.86 | $782.94 | $1,237.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,183.00 / $12,216.00 / $19,066.00
| Facility | | $3,183.00 | $12,216.00 | $19,066.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,141.24 / $24,393.30 / $26,542.00
| Facility | | $6,141.24 | $24,393.30 | $26,542.00 |