- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $378.42 / $1,693.53 / $14,063.00
| Facility | | $378.42 | $1,693.53 | $14,063.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,411.35 / $9,011.00 / $20,784.00
| Facility | | $1,411.35 | $9,011.00 | $20,784.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $366.74 / $476.76 / $2,178.56
| Facility | | $366.74 | $476.76 | $2,178.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,116.34 / $2,116.34 / $2,508.71
| Facility | | $2,116.34 | $2,116.34 | $2,508.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,719.19 / $7,672.00 / $11,284.00
| Facility | | $2,719.19 | $7,672.00 | $11,284.00 |