- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $829.73 / $2,132.41 / $16,042.00
| Facility | | $829.73 | $2,132.41 | $16,042.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,322.00 / $12,191.00 / $30,900.00
| Facility | | $4,322.00 | $12,191.00 | $30,900.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $830.14 / $1,139.40 / $1,709.10
| Facility | | $830.14 | $1,139.40 | $1,709.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,197.00 / $6,197.00 / $7,345.93
| Facility | | $6,197.00 | $6,197.00 | $7,345.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,472.00 / $10,113.00 / $15,750.00
| Facility | | $4,472.00 | $10,113.00 | $15,750.00 |