- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $783.03 / $7,273.07 / $16,467.00
| Facility | | $783.03 | $7,273.07 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,753.73 / $4,006.27 / $6,725.20
| Facility | | $1,753.73 | $4,006.27 | $6,725.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $580.00 / $772.86 / $2,581.96
| Facility | | $580.00 | $772.86 | $2,581.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $697.19 / $946.49 / $1,388.64
| Facility | | $697.19 | $946.49 | $1,388.64 |
- 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 |