- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $578.10 / $5,866.00 / $16,467.00
| Facility | | $578.10 | $5,866.00 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,911.85 / $7,206.40 / $12,212.57
| Facility | | $2,911.85 | $7,206.40 | $12,212.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $505.00 / $576.58 / $5,740.31
| Facility | | $505.00 | $576.58 | $5,740.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $514.00 / $689.00 / $1,119.45
| Facility | | $514.00 | $689.00 | $1,119.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,155.00 / $12,456.00 / $19,591.00
| Facility | | $2,155.00 | $12,456.00 | $19,591.00 |