- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $568.82 / $4,846.00 / $13,164.50
| Facility | | $568.82 | $4,846.00 | $13,164.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,473.00 / $7,890.00 / $32,252.00
| Facility | | $3,473.00 | $7,890.00 | $32,252.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $587.07 / $773.56 / $1,160.33
| Facility | | $587.07 | $773.56 | $1,160.33 |
- 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
- $3,932.00 / $8,348.00 / $12,569.00
| Facility | | $3,932.00 | $8,348.00 | $12,569.00 |