- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $704.52 / $2,768.00 / $7,542.00
| Facility | | $704.52 | $2,768.00 | $7,542.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,711.85 / $3,038.26 / $5,844.30
| Facility | | $1,711.85 | $3,038.26 | $5,844.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $546.91 / $546.91 / $571.03
| Facility | | $546.91 | $546.91 | $571.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,263.04 / $1,263.04 / $1,304.32
| Facility | | $1,263.04 | $1,263.04 | $1,304.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,819.45 / $16,394.00 / $16,394.00
| Facility | | $5,819.45 | $16,394.00 | $16,394.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $619.20 / $771.31 / $1,151.76
| Facility | | $619.20 | $771.31 | $1,151.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $613.76 / $785.38 / $1,253.38
| Facility | | $613.76 | $785.38 | $1,253.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,120.00 / $3,264.00 / $7,600.00
| Facility | | $1,120.00 | $3,264.00 | $7,600.00 |