- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,020.00 / $4,738.24 / $7,993.00
| Facility | | $1,020.00 | $4,738.24 | $7,993.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,623.56 / $3,623.56 / $3,676.44
| Facility | | $3,623.56 | $3,623.56 | $3,676.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $606.10 / $606.10 / $9,395.02
| Facility | | $606.10 | $606.10 | $9,395.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $644.70 / $967.00 / $1,457.02
| Facility | | $644.70 | $967.00 | $1,457.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,153.00 / $21,463.00 / $29,047.00
| Facility | | $8,153.00 | $21,463.00 | $29,047.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,450.40 / $27,100.53 / $31,048.85
| Facility | | $5,450.40 | $27,100.53 | $31,048.85 |