- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $417.37 / $6,158.31 / $9,870.00
| Facility | | $417.37 | $6,158.31 | $9,870.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,271.23 / $5,660.61 / $11,833.70
| Facility | | $2,271.23 | $5,660.61 | $11,833.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $411.59 / $505.00 / $5,740.31
| Facility | | $411.59 | $505.00 | $5,740.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $405.08 / $542.58 / $897.00
| Facility | | $405.08 | $542.58 | $897.00 |
- 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 |