- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $71.37 / $8,477.27 / $20,928.72
| Facility | | $71.37 | $8,477.27 | $20,928.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,973.60 / $6,541.64 / $12,653.65
| Facility | | $4,973.60 | $6,541.64 | $12,653.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $716.91 / $716.91 / $716.91
| Facility | | $716.91 | $716.91 | $716.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $71.37 / $132.03 / $1,775.00
| Facility | | $71.37 | $132.03 | $1,775.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $124.38 / $188.54 / $921.98
| Facility | | $124.38 | $188.54 | $921.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,108.26 / $1,512.82 / $6,043.00
| Facility | | $1,108.26 | $1,512.82 | $6,043.00 |