- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $964.17 / $2,477.92 / $14,063.00
| Facility | | $964.17 | $2,477.92 | $14,063.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,146.00 / $9,219.00 / $30,900.00
| Facility | | $4,146.00 | $9,219.00 | $30,900.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $960.65 / $1,318.53 / $1,977.80
| Facility | | $960.65 | $1,318.53 | $1,977.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,134.08 / $6,134.08 / $7,271.35
| Facility | | $6,134.08 | $6,134.08 | $7,271.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,431.00 / $12,330.00 / $17,416.00
| Facility | | $5,431.00 | $12,330.00 | $17,416.00 |