- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $696.45 / $9,062.00 / $16,467.00
| Facility | | $696.45 | $9,062.00 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,294.50 / $6,861.51 / $12,212.57
| Facility | | $3,294.50 | $6,861.51 | $12,212.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $580.00 / $694.50 / $5,740.31
| Facility | | $580.00 | $694.50 | $5,740.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $659.86 / $835.74 / $1,316.97
| Facility | | $659.86 | $835.74 | $1,316.97 |
- 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 |