- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $930.29 / $8,783.00 / $16,639.00
| Facility | | $930.29 | $8,783.00 | $16,639.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,801.20 / $5,844.97 / $11,769.09
| Facility | | $2,801.20 | $5,844.97 | $11,769.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $890.00 / $925.87 / $2,581.96
| Facility | | $890.00 | $925.87 | $2,581.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $851.24 / $1,083.66 / $1,855.34
| Facility | | $851.24 | $1,083.66 | $1,855.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,114.00 / $12,271.00 / $22,523.00
| Facility | | $5,114.00 | $12,271.00 | $22,523.00 |