- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $585.23 / $5,866.00 / $16,467.00
| Facility | | $585.23 | $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
- $505.00 / $585.13 / $1,370.63
| Facility | | $505.00 | $585.13 | $1,370.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $554.58 / $694.23 / $1,109.36
| Facility | | $554.58 | $694.23 | $1,109.36 |
- 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 |