- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $696.81 / $9,062.00 / $16,639.00
| Facility | | $696.81 | $9,062.00 | $16,639.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,318.29 / $10,195.20 / $17,877.47
| Facility | | $3,318.29 | $10,195.20 | $17,877.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $580.00 / $691.89 / $5,740.31
| Facility | | $580.00 | $691.89 | $5,740.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $664.96 / $864.18 / $1,333.23
| Facility | | $664.96 | $864.18 | $1,333.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,028.00 / $19,526.00 / $24,161.00
| Facility | | $3,028.00 | $19,526.00 | $24,161.00 |