- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $717.32 / $8,783.00 / $16,639.00
| Facility | | $717.32 | $8,783.00 | $16,639.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,675.35 / $10,195.20 / $18,018.52
| Facility | | $4,675.35 | $10,195.20 | $18,018.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $717.55 / $890.00 / $7,958.61
| Facility | | $717.55 | $890.00 | $7,958.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $646.30 / $830.81 / $1,365.77
| Facility | | $646.30 | $830.81 | $1,365.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,028.00 / $19,526.00 / $24,161.00
| Facility | | $3,028.00 | $19,526.00 | $24,161.00 |