- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $500.88 / $4,375.00 / $16,467.00
| Facility | | $500.88 | $4,375.00 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,753.84 / $3,754.30 / $6,096.79
| Facility | | $1,753.84 | $3,754.30 | $6,096.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $511.85 / $1,100.00 / $1,370.63
| Facility | | $511.85 | $1,100.00 | $1,370.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $447.26 / $532.00 / $920.42
| Facility | | $447.26 | $532.00 | $920.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $729.00 / $6,607.00 / $8,667.00
| Facility | | $729.00 | $6,607.00 | $8,667.00 |