- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $711.00 / $2,018.00 / $4,960.22
| Facility | | $711.00 | $2,018.00 | $4,960.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,490.00 / $3,140.17 / $5,357.74
| Facility | | $1,490.00 | $3,140.17 | $5,357.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,015.17 / $1,498.50 / $2,243.28
| Facility | | $1,015.17 | $1,498.50 | $2,243.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,255.94 / $2,436.52 / $3,760.04
| Facility | | $1,255.94 | $2,436.52 | $3,760.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,294.70 / $6,213.78 / $6,262.76
| Facility | | $5,294.70 | $6,213.78 | $6,262.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $465.00 / $1,508.00 / $3,383.01
| Facility | | $465.00 | $1,508.00 | $3,383.01 |