- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $646.32 / $9,062.00 / $18,276.00
| Facility | | $646.32 | $9,062.00 | $18,276.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,561.88 / $4,006.27 / $6,738.82
| Facility | | $1,561.88 | $4,006.27 | $6,738.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $645.02 / $715.00 / $2,581.96
| Facility | | $645.02 | $715.00 | $2,581.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $627.53 / $775.58 / $1,240.71
| Facility | | $627.53 | $775.58 | $1,240.71 |
- 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 |