- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $507.82 / $8,783.00 / $16,639.00
| Facility | | $507.82 | $8,783.00 | $16,639.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,453.87 / $5,252.82 / $9,681.64
| Facility | | $2,453.87 | $5,252.82 | $9,681.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $513.72 / $890.00 / $5,740.31
| Facility | | $513.72 | $890.00 | $5,740.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $455.82 / $613.95 / $974.14
| Facility | | $455.82 | $613.95 | $974.14 |
- 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 |