- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $396.41 / $1,734.24 / $11,093.00
| Facility | | $396.41 | $1,734.24 | $11,093.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,411.35 / $7,558.00 / $18,942.00
| Facility | | $1,411.35 | $7,558.00 | $18,942.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $408.22 / $537.89 / $806.84
| Facility | | $408.22 | $537.89 | $806.84 |
- 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
- $3,364.00 / $6,032.00 / $10,413.00
| Facility | | $3,364.00 | $6,032.00 | $10,413.00 |