- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $382.69 / $1,386.00 / $11,093.00
| Facility | | $382.69 | $1,386.00 | $11,093.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,318.00 / $6,474.00 / $13,758.00
| Facility | | $2,318.00 | $6,474.00 | $13,758.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $402.68 / $530.59 / $795.89
| Facility | | $402.68 | $530.59 | $795.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,116.34 / $2,116.34 / $2,508.71
| Facility | | $2,116.34 | $2,116.34 | $2,508.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,719.19 / $5,174.00 / $9,243.00
| Facility | | $2,719.19 | $5,174.00 | $9,243.00 |