- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $517.46 / $2,990.30 / $9,960.81
| Facility | | $517.46 | $2,990.30 | $9,960.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,796.00 / $6,340.00 / $30,900.00
| Facility | | $2,796.00 | $6,340.00 | $30,900.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $515.45 / $707.48 / $1,061.22
| Facility | | $515.45 | $707.48 | $1,061.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,045.59 / $6,045.59 / $7,166.45
| Facility | | $6,045.59 | $6,045.59 | $7,166.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,126.00 / $7,672.00 / $11,284.00
| Facility | | $4,126.00 | $7,672.00 | $11,284.00 |