- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $714.23 / $9,062.00 / $16,467.00
| Facility | | $714.23 | $9,062.00 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,260.92 / $4,803.12 / $8,557.95
| Facility | | $2,260.92 | $4,803.12 | $8,557.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $580.00 / $709.84 / $1,965.14
| Facility | | $580.00 | $709.84 | $1,965.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $552.00 / $714.23 / $1,371.86
| Facility | | $552.00 | $714.23 | $1,371.86 |
- 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 |