- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $583.15 / $2,318.00 / $11,093.00
| Facility | | $583.15 | $2,318.00 | $11,093.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,473.00 / $7,890.00 / $30,900.00
| Facility | | $3,473.00 | $7,890.00 | $30,900.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $580.67 / $797.01 / $1,195.52
| Facility | | $580.67 | $797.01 | $1,195.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,705.12 / $4,705.12 / $5,577.46
| Facility | | $4,705.12 | $4,705.12 | $5,577.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,846.00 / $8,348.00 / $12,569.00
| Facility | | $3,846.00 | $8,348.00 | $12,569.00 |