- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $722.25 / $9,319.56 / $21,831.94
| Facility | | $722.25 | $9,319.56 | $21,831.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,473.00 / $7,890.00 / $30,900.00
| Facility | | $3,473.00 | $7,890.00 | $30,900.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $718.78 / $986.57 / $1,479.86
| Facility | | $718.78 | $986.57 | $1,479.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,705.12 / $4,705.12 / $5,577.46
| Facility | | $4,705.12 | $4,705.12 | $5,577.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,370.00 / $10,069.00 / $15,750.00
| Facility | | $4,370.00 | $10,069.00 | $15,750.00 |