- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $534.10 / $8,836.60 / $16,467.00
| Facility | | $534.10 | $8,836.60 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,871.55 / $4,006.27 / $6,738.82
| Facility | | $1,871.55 | $4,006.27 | $6,738.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $528.28 / $580.00 / $2,581.96
| Facility | | $528.28 | $580.00 | $2,581.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $428.00 / $587.51 / $875.58
| Facility | | $428.00 | $587.51 | $875.58 |
- 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 |