- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $372.76 / $5,866.00 / $16,467.00
| Facility | | $372.76 | $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
- $373.84 / $505.00 / $1,370.63
| Facility | | $373.84 | $505.00 | $1,370.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $341.70 / $410.00 / $702.14
| Facility | | $341.70 | $410.00 | $702.14 |
- 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 |