- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $166.64 / $955.03 / $2,525.00
| Facility | | $166.64 | $955.03 | $2,525.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $731.87 / $3,675.96 / $8,304.51
| Facility | | $731.87 | $3,675.96 | $8,304.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,168.55 / $3,076.86 / $7,401.81
| Facility | | $2,168.55 | $3,076.86 | $7,401.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,708.40 / $2,812.99 / $5,828.20
| Facility | | $1,708.40 | $2,812.99 | $5,828.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $209.13 / $884.39 / $3,312.00
| Facility | | $209.13 | $884.39 | $3,312.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,740.00 / $4,289.00 / $8,193.00
| Facility | | $2,740.00 | $4,289.00 | $8,193.00 |