- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $842.63 / $9,062.00 / $18,276.00
| Facility | | $842.63 | $9,062.00 | $18,276.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,154.44 / $6,537.29 / $11,190.33
| Facility | | $3,154.44 | $6,537.29 | $11,190.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $715.00 / $833.63 / $3,357.67
| Facility | | $715.00 | $833.63 | $3,357.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $762.62 / $982.27 / $1,524.38
| Facility | | $762.62 | $982.27 | $1,524.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,155.00 / $12,456.00 / $19,591.00
| Facility | | $2,155.00 | $12,456.00 | $19,591.00 |