- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $737.81 / $8,783.00 / $16,639.00
| Facility | | $737.81 | $8,783.00 | $16,639.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,709.21 / $5,540.43 / $8,981.33
| Facility | | $2,709.21 | $5,540.43 | $8,981.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $580.00 / $580.00 / $1,604.11
| Facility | | $580.00 | $580.00 | $1,604.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $634.26 / $752.57 / $1,001.82
| Facility | | $634.26 | $752.57 | $1,001.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $659.00 / $6,607.00 / $8,667.00
| Facility | | $659.00 | $6,607.00 | $8,667.00 |