- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $680.34 / $1,748.47 / $11,093.00
| Facility | | $680.34 | $1,748.47 | $11,093.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,411.35 / $7,558.00 / $18,942.00
| Facility | | $1,411.35 | $7,558.00 | $18,942.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $674.21 / $925.39 / $1,388.09
| Facility | | $674.21 | $925.39 | $1,388.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,610.75 / $1,610.75 / $1,909.39
| Facility | | $1,610.75 | $1,610.75 | $1,909.39 |
- 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 |