- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $576.69 / $2,318.00 / $14,063.00
| Facility | | $576.69 | $2,318.00 | $14,063.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,807.00 / $7,833.00 / $14,645.00
| Facility | | $2,807.00 | $7,833.00 | $14,645.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $576.30 / $791.01 / $1,186.52
| Facility | | $576.30 | $791.01 | $1,186.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,116.34 / $2,116.34 / $2,508.71
| Facility | | $2,116.34 | $2,116.34 | $2,508.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,846.00 / $8,348.00 / $12,569.00
| Facility | | $3,846.00 | $8,348.00 | $12,569.00 |