- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $683.76 / $1,757.26 / $11,093.00
| Facility | | $683.76 | $1,757.26 | $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
- $684.33 / $939.27 / $1,408.91
| Facility | | $684.33 | $939.27 | $1,408.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,379.37 / $11,379.37 / $13,489.13
| Facility | | $11,379.37 | $11,379.37 | $13,489.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,058.00 / $12,330.00 / $17,649.00
| Facility | | $5,058.00 | $12,330.00 | $17,649.00 |