- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $367.87 / $6,548.00 / $16,467.00
| Facility | | $367.87 | $6,548.00 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,435.81 / $5,214.16 / $8,752.84
| Facility | | $2,435.81 | $5,214.16 | $8,752.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $545.65 / $580.00 / $2,581.96
| Facility | | $545.65 | $580.00 | $2,581.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $370.12 / $593.92 / $906.46
| Facility | | $370.12 | $593.92 | $906.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,550.00 / $10,257.00 / $16,249.00
| Facility | | $1,550.00 | $10,257.00 | $16,249.00 |