- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $450.31 / $9,062.00 / $18,276.00
| Facility | | $450.31 | $9,062.00 | $18,276.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,347.39 / $5,104.41 / $8,656.01
| Facility | | $2,347.39 | $5,104.41 | $8,656.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $452.71 / $715.00 / $1,370.63
| Facility | | $452.71 | $715.00 | $1,370.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $430.69 / $540.37 / $848.75
| Facility | | $430.69 | $540.37 | $848.75 |
- 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 |