- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $701.83 / $9,062.00 / $18,276.00
| Facility | | $701.83 | $9,062.00 | $18,276.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,366.50 / $6,861.51 / $12,212.57
| Facility | | $3,366.50 | $6,861.51 | $12,212.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $705.06 / $715.00 / $2,581.96
| Facility | | $705.06 | $715.00 | $2,581.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $664.02 / $893.78 / $1,336.04
| Facility | | $664.02 | $893.78 | $1,336.04 |
- 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 |