- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $492.97 / $2,318.00 / $16,042.00
| Facility | | $492.97 | $2,318.00 | $16,042.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,390.00 / $10,182.00 / $16,615.00
| Facility | | $3,390.00 | $10,182.00 | $16,615.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $489.40 / $671.72 / $1,007.58
| Facility | | $489.40 | $671.72 | $1,007.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,705.12 / $4,705.12 / $5,577.46
| Facility | | $4,705.12 | $4,705.12 | $5,577.46 |
- 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 |