- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $998.71 / $8,716.00 / $16,467.00
| Facility | | $998.71 | $8,716.00 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,262.07 / $9,123.49 / $15,497.92
| Facility | | $4,262.07 | $9,123.49 | $15,497.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $815.00 / $991.33 / $14,376.12
| Facility | | $815.00 | $991.33 | $14,376.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $965.39 / $1,208.44 / $1,908.72
| Facility | | $965.39 | $1,208.44 | $1,908.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,912.00 / $16,223.00 / $23,485.00
| Facility | | $2,912.00 | $16,223.00 | $23,485.00 |