- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $773.48 / $9,062.00 / $18,276.00
| Facility | | $773.48 | $9,062.00 | $18,276.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,366.50 / $7,206.40 / $12,212.57
| Facility | | $3,366.50 | $7,206.40 | $12,212.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $771.12 / $1,100.00 / $2,581.96
| Facility | | $771.12 | $1,100.00 | $2,581.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $697.92 / $910.57 / $1,467.95
| Facility | | $697.92 | $910.57 | $1,467.95 |
- 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 |