- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $740.46 / $7,182.00 / $12,024.12
| Facility | | $740.46 | $7,182.00 | $12,024.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,294.50 / $7,206.40 / $12,212.57
| Facility | | $3,294.50 | $7,206.40 | $12,212.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $505.00 / $734.30 / $2,581.96
| Facility | | $505.00 | $734.30 | $2,581.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $720.53 / $882.05 / $1,429.06
| Facility | | $720.53 | $882.05 | $1,429.06 |
- 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 |