- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $578.51 / $8,783.00 / $16,639.00
| Facility | | $578.51 | $8,783.00 | $16,639.00 |
- 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
- $578.05 / $580.00 / $2,581.96
| Facility | | $578.05 | $580.00 | $2,581.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $574.03 / $774.50 / $1,092.56
| Facility | | $574.03 | $774.50 | $1,092.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,114.00 / $12,271.00 / $22,523.00
| Facility | | $5,114.00 | $12,271.00 | $22,523.00 |