- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $525.60 / $1,391.00 / $14,063.00
| Facility | | $525.60 | $1,391.00 | $14,063.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,411.35 / $7,572.00 / $18,942.00
| Facility | | $1,411.35 | $7,572.00 | $18,942.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $525.91 / $721.84 / $1,082.76
| Facility | | $525.91 | $721.84 | $1,082.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,116.34 / $2,116.34 / $2,508.71
| Facility | | $2,116.34 | $2,116.34 | $2,508.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,400.00 / $3,874.00 / $5,490.00
| Facility | | $2,400.00 | $3,874.00 | $5,490.00 |