- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $823.27 / $4,541.35 / $16,042.00
| Facility | | $823.27 | $4,541.35 | $16,042.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,390.00 / $10,182.00 / $16,615.00
| Facility | | $3,390.00 | $10,182.00 | $16,615.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $731.71 / $951.22 / $1,481.72
| Facility | | $731.71 | $951.22 | $1,481.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,116.34 / $2,116.34 / $2,508.71
| Facility | | $2,116.34 | $2,116.34 | $2,508.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,699.00 / $10,113.00 / $15,750.00
| Facility | | $4,699.00 | $10,113.00 | $15,750.00 |