- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $853.30 / $9,062.00 / $18,276.00
| Facility | | $853.30 | $9,062.00 | $18,276.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,294.50 / $7,206.40 / $12,212.57
| Facility | | $3,294.50 | $7,206.40 | $12,212.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $815.00 / $854.08 / $5,740.31
| Facility | | $815.00 | $854.08 | $5,740.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $837.56 / $1,023.96 / $1,637.25
| Facility | | $837.56 | $1,023.96 | $1,637.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,155.00 / $12,456.00 / $19,591.00
| Facility | | $2,155.00 | $12,456.00 | $19,591.00 |