- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $731.03 / $7,499.46 / $16,467.00
| Facility | | $731.03 | $7,499.46 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,911.85 / $6,852.09 / $12,097.16
| Facility | | $2,911.85 | $6,852.09 | $12,097.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $715.00 / $730.20 / $2,581.96
| Facility | | $715.00 | $730.20 | $2,581.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $723.05 / $900.26 / $1,527.15
| Facility | | $723.05 | $900.26 | $1,527.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,327.00 / $12,798.00 / $23,771.00
| Facility | | $2,327.00 | $12,798.00 | $23,771.00 |