- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $580.38 / $7,799.00 / $11,119.07
| Facility | | $580.38 | $7,799.00 | $11,119.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,822.83 / $6,852.09 / $12,492.30
| Facility | | $2,822.83 | $6,852.09 | $12,492.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $505.00 / $580.66 / $2,581.96
| Facility | | $505.00 | $580.66 | $2,581.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $577.46 / $719.00 / $1,203.34
| Facility | | $577.46 | $719.00 | $1,203.34 |
- 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 |