- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $643.84 / $4,204.20 / $16,467.00
| Facility | | $643.84 | $4,204.20 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,294.50 / $7,206.40 / $12,097.16
| Facility | | $3,294.50 | $7,206.40 | $12,097.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $641.67 / $815.00 / $2,581.96
| Facility | | $641.67 | $815.00 | $2,581.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $570.37 / $773.00 / $1,230.79
| Facility | | $570.37 | $773.00 | $1,230.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,155.00 / $12,456.00 / $19,591.00
| Facility | | $2,155.00 | $12,456.00 | $19,591.00 |