- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $496.34 / $3,881.43 / $14,060.00
| Facility | | $496.34 | $3,881.43 | $14,060.00 |
- 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
- $498.18 / $683.77 / $1,025.66
| Facility | | $498.18 | $683.77 | $1,025.66 |
- 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
- $3,932.00 / $8,348.00 / $12,569.00
| Facility | | $3,932.00 | $8,348.00 | $12,569.00 |