- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $809.80 / $2,318.00 / $16,042.00
| Facility | | $809.80 | $2,318.00 | $16,042.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,322.00 / $12,289.00 / $37,919.46
| Facility | | $4,322.00 | $12,289.00 | $37,919.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $806.34 / $1,106.74 / $1,660.11
| Facility | | $806.34 | $1,106.74 | $1,660.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,783.58 / $11,783.58 / $13,968.28
| Facility | | $11,783.58 | $11,783.58 | $13,968.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,472.00 / $10,113.00 / $17,623.00
| Facility | | $4,472.00 | $10,113.00 | $17,623.00 |