- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $805.66 / $2,318.00 / $11,093.00
| Facility | | $805.66 | $2,318.00 | $11,093.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,065.00 / $7,890.00 / $37,919.46
| Facility | | $3,065.00 | $7,890.00 | $37,919.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $798.77 / $1,096.34 / $1,644.53
| Facility | | $798.77 | $1,096.34 | $1,644.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,405.61 / $12,405.61 / $14,705.63
| Facility | | $12,405.61 | $12,405.61 | $14,705.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,058.00 / $12,330.00 / $17,416.00
| Facility | | $5,058.00 | $12,330.00 | $17,416.00 |