- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $319.92 / $4,782.97 / $7,212.00
| Facility | | $319.92 | $4,782.97 | $7,212.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,705.10 / $16,700.00 / $33,821.32
| Facility | | $2,705.10 | $16,700.00 | $33,821.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $316.14 / $433.93 / $720.63
| Facility | | $316.14 | $433.93 | $720.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,581.86 / $6,581.86 / $7,802.14
| Facility | | $6,581.86 | $6,581.86 | $7,802.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,058.00 / $12,330.00 / $17,416.00
| Facility | | $5,058.00 | $12,330.00 | $17,416.00 |