- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $818.37 / $9,062.00 / $18,276.00
| Facility | | $818.37 | $9,062.00 | $18,276.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,366.50 / $7,263.19 / $12,212.57
| Facility | | $3,366.50 | $7,263.19 | $12,212.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $817.25 / $1,100.00 / $2,581.96
| Facility | | $817.25 | $1,100.00 | $2,581.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $791.46 / $974.05 / $1,567.84
| Facility | | $791.46 | $974.05 | $1,567.84 |
- 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 |