- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $505.38 / $3,016.49 / $16,467.00
| Facility | | $505.38 | $3,016.49 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,453.87 / $5,096.67 / $8,705.65
| Facility | | $2,453.87 | $5,096.67 | $8,705.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.23 / $890.00 / $2,581.96
| Facility | | $501.23 | $890.00 | $2,581.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $458.00 / $599.05 / $977.62
| Facility | | $458.00 | $599.05 | $977.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,550.00 / $10,257.00 / $16,249.00
| Facility | | $1,550.00 | $10,257.00 | $16,249.00 |