- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $781.56 / $2,453.00 / $16,042.00
| Facility | | $781.56 | $2,453.00 | $16,042.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,322.00 / $12,455.00 / $37,919.46
| Facility | | $4,322.00 | $12,455.00 | $37,919.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $811.29 / $1,069.00 / $1,603.50
| Facility | | $811.29 | $1,069.00 | $1,603.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,358.65 / $11,358.65 / $13,464.57
| Facility | | $11,358.65 | $11,358.65 | $13,464.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,431.00 / $12,393.00 / $18,911.00
| Facility | | $5,431.00 | $12,393.00 | $18,911.00 |