- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $464.94 / $5,866.00 / $16,467.00
| Facility | | $464.94 | $5,866.00 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,347.39 / $5,252.82 / $9,681.64
| Facility | | $2,347.39 | $5,252.82 | $9,681.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $465.35 / $505.00 / $2,581.96
| Facility | | $465.35 | $505.00 | $2,581.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $442.69 / $546.00 / $877.72
| Facility | | $442.69 | $546.00 | $877.72 |
- 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 |