- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $674.68 / $5,866.00 / $16,467.00
| Facility | | $674.68 | $5,866.00 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,347.39 / $5,205.85 / $8,705.65
| Facility | | $2,347.39 | $5,205.85 | $8,705.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $505.00 / $676.64 / $5,740.31
| Facility | | $505.00 | $676.64 | $5,740.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $661.00 / $872.38 / $1,284.33
| Facility | | $661.00 | $872.38 | $1,284.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,550.00 / $10,257.00 / $16,249.00
| Facility | | $1,550.00 | $10,257.00 | $16,249.00 |