- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $638.83 / $9,062.00 / $18,276.00
| Facility | | $638.83 | $9,062.00 | $18,276.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,154.44 / $6,537.29 / $11,190.33
| Facility | | $3,154.44 | $6,537.29 | $11,190.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $637.95 / $715.00 / $2,581.96
| Facility | | $637.95 | $715.00 | $2,581.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $605.57 / $757.41 / $1,209.46
| Facility | | $605.57 | $757.41 | $1,209.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,155.00 / $12,456.00 / $19,591.00
| Facility | | $2,155.00 | $12,456.00 | $19,591.00 |