- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $786.31 / $7,650.73 / $16,467.00
| Facility | | $786.31 | $7,650.73 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,871.55 / $3,916.77 / $6,738.82
| Facility | | $1,871.55 | $3,916.77 | $6,738.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $715.00 / $775.47 / $2,581.96
| Facility | | $715.00 | $775.47 | $2,581.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $659.19 / $913.95 / $1,386.36
| Facility | | $659.19 | $913.95 | $1,386.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $729.00 / $6,607.00 / $8,667.00
| Facility | | $729.00 | $6,607.00 | $8,667.00 |