- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $465.51 / $1,595.44 / $16,467.00
| Facility | | $465.51 | $1,595.44 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,435.81 / $5,095.07 / $8,656.54
| Facility | | $2,435.81 | $5,095.07 | $8,656.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $580.00 / $700.21 / $2,581.96
| Facility | | $580.00 | $700.21 | $2,581.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $465.51 / $721.53 / $1,082.61
| Facility | | $465.51 | $721.53 | $1,082.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,550.00 / $9,904.00 / $16,249.00
| Facility | | $1,550.00 | $9,904.00 | $16,249.00 |