- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $548.10 / $8,783.00 / $16,639.00
| Facility | | $548.10 | $8,783.00 | $16,639.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,347.39 / $5,154.55 / $8,705.65
| Facility | | $2,347.39 | $5,154.55 | $8,705.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $541.71 / $580.00 / $2,581.96
| Facility | | $541.71 | $580.00 | $2,581.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $490.72 / $642.41 / $1,024.15
| Facility | | $490.72 | $642.41 | $1,024.15 |
- 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 |