- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $859.43 / $5,866.00 / $16,467.00
| Facility | | $859.43 | $5,866.00 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,294.50 / $7,206.40 / $12,097.16
| Facility | | $3,294.50 | $7,206.40 | $12,097.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $505.00 / $780.00 / $5,740.31
| Facility | | $505.00 | $780.00 | $5,740.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $854.62 / $1,074.29 / $1,692.92
| Facility | | $854.62 | $1,074.29 | $1,692.92 |
- 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 |