- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $632.28 / $2,836.65 / $11,093.00
| Facility | | $632.28 | $2,836.65 | $11,093.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,473.00 / $7,890.00 / $30,900.00
| Facility | | $3,473.00 | $7,890.00 | $30,900.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $631.67 / $867.01 / $1,300.52
| Facility | | $631.67 | $867.01 | $1,300.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,348.83 / $6,348.83 / $7,525.91
| Facility | | $6,348.83 | $6,348.83 | $7,525.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,058.00 / $12,330.00 / $17,416.00
| Facility | | $5,058.00 | $12,330.00 | $17,416.00 |