- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $713.53 / $713.53 / $7,397.00
| Facility | | $713.53 | $713.53 | $7,397.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,783.95 / $4,712.87 / $9,166.61
| Facility | | $2,783.95 | $4,712.87 | $9,166.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,668.51 / $2,367.37 / $5,695.03
| Facility | | $1,668.51 | $2,367.37 | $5,695.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,357.08 / $2,164.34 / $4,484.28
| Facility | | $1,357.08 | $2,164.34 | $4,484.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $677.41 / $1,239.89 / $5,625.11
| Facility | | $677.41 | $1,239.89 | $5,625.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,735.00 / $4,974.00 / $8,812.00
| Facility | | $2,735.00 | $4,974.00 | $8,812.00 |