- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $565.57 / $5,866.00 / $16,467.00
| Facility | | $565.57 | $5,866.00 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,753.73 / $4,006.27 / $6,738.82
| Facility | | $1,753.73 | $4,006.27 | $6,738.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $505.00 / $565.41 / $2,581.96
| Facility | | $505.00 | $565.41 | $2,581.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $547.38 / $684.34 / $1,076.51
| Facility | | $547.38 | $684.34 | $1,076.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $729.00 / $6,607.00 / $8,667.00
| Facility | | $729.00 | $6,607.00 | $8,667.00 |