- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $530.57 / $1,245.00 / $8,413.00
| Facility | | $530.57 | $1,245.00 | $8,413.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $606.10 / $606.10 / $8,046.88
| Facility | | $606.10 | $606.10 | $8,046.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $530.57 / $644.83 / $1,199.08
| Facility | | $530.57 | $644.83 | $1,199.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,183.00 / $12,216.00 / $19,066.00
| Facility | | $3,183.00 | $12,216.00 | $19,066.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,060.36 / $26,542.00 / $26,593.50
| Facility | | $2,060.36 | $26,542.00 | $26,593.50 |