- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $633.70 / $5,866.00 / $16,467.00
| Facility | | $633.70 | $5,866.00 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,753.73 / $3,945.39 / $6,725.20
| Facility | | $1,753.73 | $3,945.39 | $6,725.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $505.00 / $635.35 / $1,370.63
| Facility | | $505.00 | $635.35 | $1,370.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $556.58 / $728.76 / $1,191.14
| Facility | | $556.58 | $728.76 | $1,191.14 |
- 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 |