- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $801.44 / $9,062.00 / $18,276.00
| Facility | | $801.44 | $9,062.00 | $18,276.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,109.54 / $10,783.42 / $18,314.23
| Facility | | $5,109.54 | $10,783.42 | $18,314.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $800.88 / $815.00 / $5,740.31
| Facility | | $800.88 | $815.00 | $5,740.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $723.90 / $961.73 / $1,533.54
| Facility | | $723.90 | $961.73 | $1,533.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,912.00 / $16,223.00 / $23,485.00
| Facility | | $2,912.00 | $16,223.00 | $23,485.00 |