- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $618.05 / $9,450.00 / $16,467.00
| Facility | | $618.05 | $9,450.00 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,347.39 / $5,205.85 / $8,656.01
| Facility | | $2,347.39 | $5,205.85 | $8,656.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $617.49 / $890.00 / $2,581.96
| Facility | | $617.49 | $890.00 | $2,581.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $552.54 / $682.06 / $1,178.93
| Facility | | $552.54 | $682.06 | $1,178.93 |
- 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 |