- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $783.51 / $1,933.00 / $12,247.00
| Facility | | $783.51 | $1,933.00 | $12,247.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,182.48 / $1,182.48 / $5,006.99
| Facility | | $1,182.48 | $1,182.48 | $5,006.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $783.51 / $970.06 / $1,744.00
| Facility | | $783.51 | $970.06 | $1,744.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,183.00 / $12,216.00 / $19,066.00
| Facility | | $3,183.00 | $12,216.00 | $19,066.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,000.00 / $14,442.95 / $16,547.20
| Facility | | $2,000.00 | $14,442.95 | $16,547.20 |