- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $987.73 / $9,863.00 / $14,769.38
| Facility | | $987.73 | $9,863.00 | $14,769.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,347.39 / $5,060.37 / $8,705.65
| Facility | | $2,347.39 | $5,060.37 | $8,705.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $433.37 / $580.00 / $2,581.96
| Facility | | $433.37 | $580.00 | $2,581.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $404.81 / $508.00 / $814.43
| Facility | | $404.81 | $508.00 | $814.43 |
- 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 |