- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $567.84 / $5,515.65 / $16,467.00
| Facility | | $567.84 | $5,515.65 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,753.73 / $3,989.66 / $6,725.20
| Facility | | $1,753.73 | $3,989.66 | $6,725.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $567.27 / $580.00 / $1,370.63
| Facility | | $567.27 | $580.00 | $1,370.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $494.96 / $658.32 / $1,079.03
| Facility | | $494.96 | $658.32 | $1,079.03 |
- 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 |