- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $470.10 / $2,346.48 / $17,225.00
| Facility | | $470.10 | $2,346.48 | $17,225.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,601.00 / $10,503.00 / $19,482.00
| Facility | | $3,601.00 | $10,503.00 | $19,482.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $460.60 / $598.78 / $690.90
| Facility | | $460.60 | $598.78 | $690.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,116.34 / $2,116.34 / $2,508.71
| Facility | | $2,116.34 | $2,116.34 | $2,508.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,400.00 / $3,874.00 / $5,490.00
| Facility | | $2,400.00 | $3,874.00 | $5,490.00 |