- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $784.46 / $4,580.00 / $17,225.00
| Facility | | $784.46 | $4,580.00 | $17,225.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,601.00 / $10,503.00 / $19,482.00
| Facility | | $3,601.00 | $10,503.00 | $19,482.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $756.26 / $983.14 / $1,134.39
| Facility | | $756.26 | $983.14 | $1,134.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,735.18 / $2,735.18 / $3,242.29
| Facility | | $2,735.18 | $2,735.18 | $3,242.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,932.00 / $8,348.00 / $12,569.00
| Facility | | $3,932.00 | $8,348.00 | $12,569.00 |