- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $499.58 / $9,062.00 / $18,276.00
| Facility | | $499.58 | $9,062.00 | $18,276.00 |
- 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
- $501.07 / $715.00 / $2,581.96
| Facility | | $501.07 | $715.00 | $2,581.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $476.08 / $604.91 / $949.41
| Facility | | $476.08 | $604.91 | $949.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,155.00 / $12,456.00 / $19,591.00
| Facility | | $2,155.00 | $12,456.00 | $19,591.00 |