- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $562.80 / $1,564.08 / $16,467.00
| Facility | | $562.80 | $1,564.08 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,799.77 / $3,852.64 / $6,494.50
| Facility | | $1,799.77 | $3,852.64 | $6,494.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $580.00 / $848.53 / $1,604.11
| Facility | | $580.00 | $848.53 | $1,604.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $535.57 / $731.65 / $1,180.20
| Facility | | $535.57 | $731.65 | $1,180.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,550.00 / $10,257.00 / $16,249.00
| Facility | | $1,550.00 | $10,257.00 | $16,249.00 |