- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $782.78 / $8,783.00 / $16,639.00
| Facility | | $782.78 | $8,783.00 | $16,639.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,453.87 / $5,205.85 / $8,724.34
| Facility | | $2,453.87 | $5,205.85 | $8,724.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $580.00 / $776.70 / $1,370.63
| Facility | | $580.00 | $776.70 | $1,370.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $740.00 / $939.34 / $1,485.49
| Facility | | $740.00 | $939.34 | $1,485.49 |
- 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 |