- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $390.86 / $3,508.40 / $16,467.00
| Facility | | $390.86 | $3,508.40 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,871.55 / $4,029.38 / $6,738.82
| Facility | | $1,871.55 | $4,029.38 | $6,738.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $392.07 / $715.00 / $2,581.96
| Facility | | $392.07 | $715.00 | $2,581.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $365.00 / $439.00 / $732.69
| Facility | | $365.00 | $439.00 | $732.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,471.00 / $5,249.00 / $9,900.00
| Facility | | $1,471.00 | $5,249.00 | $9,900.00 |