- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $531.04 / $8,783.00 / $16,639.00
| Facility | | $531.04 | $8,783.00 | $16,639.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,753.73 / $3,989.66 / $6,738.82
| Facility | | $1,753.73 | $3,989.66 | $6,738.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.92 / $580.00 / $1,370.63
| Facility | | $524.92 | $580.00 | $1,370.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $414.19 / $584.14 / $867.93
| Facility | | $414.19 | $584.14 | $867.93 |
- 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 |