- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $466.14 / $2,318.00 / $7,954.00
| Facility | | $466.14 | $2,318.00 | $7,954.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,601.00 / $10,503.00 / $19,482.00
| Facility | | $3,601.00 | $10,503.00 | $19,482.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $465.03 / $638.27 / $957.41
| Facility | | $465.03 | $638.27 | $957.41 |
- 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
- $3,364.00 / $6,032.00 / $10,413.00
| Facility | | $3,364.00 | $6,032.00 | $10,413.00 |