- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $776.80 / $9,062.00 / $16,639.00
| Facility | | $776.80 | $9,062.00 | $16,639.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,377.03 / $15,711.56 / $31,882.31
| Facility | | $5,377.03 | $15,711.56 | $31,882.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $580.00 / $771.87 / $7,937.82
| Facility | | $580.00 | $771.87 | $7,937.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $766.09 / $1,027.00 / $1,481.46
| Facility | | $766.09 | $1,027.00 | $1,481.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,912.00 / $16,223.00 / $23,485.00
| Facility | | $2,912.00 | $16,223.00 | $23,485.00 |