- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $373.29 / $1,386.00 / $17,225.00
| Facility | | $373.29 | $1,386.00 | $17,225.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,601.00 / $10,503.00 / $19,482.00
| Facility | | $3,601.00 | $10,503.00 | $19,482.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $373.36 / $549.05 / $770.43
| Facility | | $373.36 | $549.05 | $770.43 |
- 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
- $2,398.58 / $5,174.00 / $9,243.00
| Facility | | $2,398.58 | $5,174.00 | $9,243.00 |