- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $700.32 / $8,783.00 / $16,639.00
| Facility | | $700.32 | $8,783.00 | $16,639.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,866.56 / $6,304.45 / $10,605.01
| Facility | | $2,866.56 | $6,304.45 | $10,605.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $580.00 / $694.86 / $5,740.31
| Facility | | $580.00 | $694.86 | $5,740.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $670.18 / $840.38 / $1,326.88
| Facility | | $670.18 | $840.38 | $1,326.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,550.00 / $10,257.00 / $16,901.00
| Facility | | $1,550.00 | $10,257.00 | $16,901.00 |