- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $605.89 / $10,054.45 / $16,467.00
| Facility | | $605.89 | $10,054.45 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,453.87 / $5,205.85 / $8,724.34
| Facility | | $2,453.87 | $5,205.85 | $8,724.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $600.76 / $815.00 / $5,740.31
| Facility | | $600.76 | $815.00 | $5,740.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $515.17 / $670.00 / $1,139.28
| Facility | | $515.17 | $670.00 | $1,139.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,550.00 / $10,257.00 / $16,249.00
| Facility | | $1,550.00 | $10,257.00 | $16,249.00 |