- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $479.27 / $8,783.00 / $16,639.00
| Facility | | $479.27 | $8,783.00 | $16,639.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,453.87 / $5,294.21 / $9,681.64
| Facility | | $2,453.87 | $5,294.21 | $9,681.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $488.78 / $580.00 / $5,740.31
| Facility | | $488.78 | $580.00 | $5,740.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $462.71 / $578.51 / $949.41
| Facility | | $462.71 | $578.51 | $949.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,155.00 / $12,456.00 / $19,591.00
| Facility | | $2,155.00 | $12,456.00 | $19,591.00 |