- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $246.49 / $3,776.00 / $9,727.00
| Facility | | $246.49 | $3,776.00 | $9,727.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,184.19 / $4,445.64 / $7,630.34
| Facility | | $2,184.19 | $4,445.64 | $7,630.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $368.26 / $375.00 / $1,965.14
| Facility | | $368.26 | $375.00 | $1,965.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $240.79 / $408.96 / $643.41
| Facility | | $240.79 | $408.96 | $643.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,550.00 / $10,257.00 / $16,249.00
| Facility | | $1,550.00 | $10,257.00 | $16,249.00 |