- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $607.82 / $8,783.00 / $16,639.00
| Facility | | $607.82 | $8,783.00 | $16,639.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,347.39 / $5,096.67 / $8,705.65
| Facility | | $2,347.39 | $5,096.67 | $8,705.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $580.00 / $606.71 / $2,581.96
| Facility | | $580.00 | $606.71 | $2,581.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $580.36 / $750.40 / $1,269.30
| Facility | | $580.36 | $750.40 | $1,269.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,550.00 / $10,257.00 / $16,249.00
| Facility | | $1,550.00 | $10,257.00 | $16,249.00 |