- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $453.96 / $4,846.00 / $14,063.00
| Facility | | $453.96 | $4,846.00 | $14,063.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,807.00 / $7,833.00 / $14,645.00
| Facility | | $2,807.00 | $7,833.00 | $14,645.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $444.86 / $578.32 / $667.29
| Facility | | $444.86 | $578.32 | $667.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,116.34 / $2,116.34 / $2,508.71
| Facility | | $2,116.34 | $2,116.34 | $2,508.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,138.00 / $6,032.00 / $10,413.00
| Facility | | $3,138.00 | $6,032.00 | $10,413.00 |