- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $503.68 / $1,391.00 / $14,063.00
| Facility | | $503.68 | $1,391.00 | $14,063.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,411.35 / $7,572.00 / $18,942.00
| Facility | | $1,411.35 | $7,572.00 | $18,942.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $504.38 / $692.29 / $1,038.44
| Facility | | $504.38 | $692.29 | $1,038.44 |
- 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
- $3,364.00 / $6,032.00 / $10,413.00
| Facility | | $3,364.00 | $6,032.00 | $10,413.00 |