- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $418.41 / $5,889.00 / $9,062.00
| Facility | | $418.41 | $5,889.00 | $9,062.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,441.81 / $5,267.76 / $8,927.19
| Facility | | $2,441.81 | $5,267.76 | $8,927.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $505.00 / $631.58 / $1,965.14
| Facility | | $505.00 | $631.58 | $1,965.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $371.25 / $597.41 / $1,002.97
| Facility | | $371.25 | $597.41 | $1,002.97 |
- 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 |