- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $408.31 / $4,347.50 / $16,467.00
| Facility | | $408.31 | $4,347.50 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,347.39 / $5,154.55 / $8,724.34
| Facility | | $2,347.39 | $5,154.55 | $8,724.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $580.00 / $613.41 / $2,581.96
| Facility | | $580.00 | $613.41 | $2,581.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $408.31 / $636.00 / $1,033.08
| Facility | | $408.31 | $636.00 | $1,033.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,550.00 / $10,878.00 / $16,772.00
| Facility | | $1,550.00 | $10,878.00 | $16,772.00 |