- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $786.34 / $8,783.00 / $16,467.00
| Facility | | $786.34 | $8,783.00 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,737.00 / $3,870.04 / $6,700.72
| Facility | | $1,737.00 | $3,870.04 | $6,700.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $580.00 / $777.32 / $1,370.63
| Facility | | $580.00 | $777.32 | $1,370.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $706.19 / $951.47 / $1,517.54
| Facility | | $706.19 | $951.47 | $1,517.54 |
- 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 |