- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $673.38 / $5,866.00 / $16,467.00
| Facility | | $673.38 | $5,866.00 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,294.50 / $7,147.42 / $12,097.16
| Facility | | $3,294.50 | $7,147.42 | $12,097.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $505.00 / $671.81 / $2,581.96
| Facility | | $505.00 | $671.81 | $2,581.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $672.25 / $851.80 / $1,276.69
| Facility | | $672.25 | $851.80 | $1,276.69 |
- 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 |