- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $657.65 / $8,783.00 / $16,639.00
| Facility | | $657.65 | $8,783.00 | $16,639.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,347.39 / $5,154.55 / $8,724.34
| Facility | | $2,347.39 | $5,154.55 | $8,724.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $580.00 / $655.17 / $2,581.96
| Facility | | $580.00 | $655.17 | $2,581.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $571.20 / $780.00 / $1,252.14
| Facility | | $571.20 | $780.00 | $1,252.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,550.00 / $10,257.00 / $16,249.00
| Facility | | $1,550.00 | $10,257.00 | $16,249.00 |