- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $814.59 / $5,866.00 / $16,467.00
| Facility | | $814.59 | $5,866.00 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $924.04 / $2,033.98 / $3,486.32
| Facility | | $924.04 | $2,033.98 | $3,486.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $505.00 / $780.00 / $1,158.06
| Facility | | $505.00 | $780.00 | $1,158.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $672.49 / $915.97 / $1,533.54
| Facility | | $672.49 | $915.97 | $1,533.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $490.00 / $3,866.00 / $6,584.00
| Facility | | $490.00 | $3,866.00 | $6,584.00 |