- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $520.48 / $4,297.27 / $16,467.00
| Facility | | $520.48 | $4,297.27 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,366.50 / $7,206.40 / $12,097.16
| Facility | | $3,366.50 | $7,206.40 | $12,097.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $522.64 / $580.00 / $2,581.96
| Facility | | $522.64 | $580.00 | $2,581.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $498.05 / $629.78 / $978.38
| Facility | | $498.05 | $629.78 | $978.38 |
- 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 |