- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $606.08 / $8,783.00 / $16,639.00
| Facility | | $606.08 | $8,783.00 | $16,639.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,911.85 / $6,861.51 / $12,097.16
| Facility | | $2,911.85 | $6,861.51 | $12,097.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $580.00 / $605.91 / $2,581.96
| Facility | | $580.00 | $605.91 | $2,581.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $606.08 / $785.00 / $1,210.17
| Facility | | $606.08 | $785.00 | $1,210.17 |
- 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 |