- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $352.63 / $4,440.80 / $16,467.00
| Facility | | $352.63 | $4,440.80 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,388.54 / $5,405.49 / $8,981.33
| Facility | | $2,388.54 | $5,405.49 | $8,981.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $715.00 / $715.00 / $1,604.11
| Facility | | $715.00 | $715.00 | $1,604.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $315.38 / $433.88 / $608.99
| Facility | | $315.38 | $433.88 | $608.99 |
- 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 |