- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $725.13 / $8,783.00 / $16,639.00
| Facility | | $725.13 | $8,783.00 | $16,639.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,366.50 / $7,206.40 / $12,212.57
| Facility | | $3,366.50 | $7,206.40 | $12,212.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $728.60 / $890.00 / $5,740.31
| Facility | | $728.60 | $890.00 | $5,740.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $725.13 / $924.72 / $1,421.44
| Facility | | $725.13 | $924.72 | $1,421.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,114.00 / $12,456.00 / $22,523.00
| Facility | | $5,114.00 | $12,456.00 | $22,523.00 |