- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $447.51 / $4,846.00 / $17,225.00
| Facility | | $447.51 | $4,846.00 | $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
- $439.01 / $570.71 / $658.52
| Facility | | $439.01 | $570.71 | $658.52 |
- 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
- $3,364.00 / $6,032.00 / $10,413.00
| Facility | | $3,364.00 | $6,032.00 | $10,413.00 |