- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $670.88 / $4,846.00 / $9,366.76
| Facility | | $670.88 | $4,846.00 | $9,366.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,473.00 / $7,890.00 / $30,900.00
| Facility | | $3,473.00 | $7,890.00 | $30,900.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $671.71 / $921.96 / $1,382.94
| Facility | | $671.71 | $921.96 | $1,382.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,951.40 / $5,951.40 / $7,054.80
| Facility | | $5,951.40 | $5,951.40 | $7,054.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,472.00 / $10,113.00 / $15,750.00
| Facility | | $4,472.00 | $10,113.00 | $15,750.00 |