- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $606.79 / $1,245.00 / $10,924.00
| Facility | | $606.79 | $1,245.00 | $10,924.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,665.09 / $3,665.09 / $3,718.57
| Facility | | $3,665.09 | $3,665.09 | $3,718.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $852.10 / $852.10 / $2,710.28
| Facility | | $852.10 | $852.10 | $2,710.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $606.79 / $835.24 / $1,210.19
| Facility | | $606.79 | $835.24 | $1,210.19 |
- 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
- $3,508.56 / $8,957.00 / $26,542.00
| Facility | | $3,508.56 | $8,957.00 | $26,542.00 |