- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $907.28 / $2,331.71 / $11,093.00
| Facility | | $907.28 | $2,331.71 | $11,093.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,473.00 / $7,890.00 / $30,900.00
| Facility | | $3,473.00 | $7,890.00 | $30,900.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $900.93 / $1,236.56 / $1,854.84
| Facility | | $900.93 | $1,236.56 | $1,854.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,338.68 / $6,338.68 / $7,513.89
| Facility | | $6,338.68 | $6,338.68 | $7,513.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,058.00 / $12,330.00 / $17,416.00
| Facility | | $5,058.00 | $12,330.00 | $17,416.00 |