- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $442.23 / $9,062.00 / $18,276.00
| Facility | | $442.23 | $9,062.00 | $18,276.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,085.44 / $4,452.39 / $7,418.57
| Facility | | $2,085.44 | $4,452.39 | $7,418.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $444.18 / $1,100.00 / $1,512.28
| Facility | | $444.18 | $1,100.00 | $1,512.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $426.71 / $531.08 / $838.83
| Facility | | $426.71 | $531.08 | $838.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,981.00 / $10,147.00 / $16,816.00
| Facility | | $1,981.00 | $10,147.00 | $16,816.00 |