- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $491.12 / $1,617.62 / $16,467.00
| Facility | | $491.12 | $1,617.62 | $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 / $726.45 / $2,581.96
| Facility | | $580.00 | $726.45 | $2,581.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $497.99 / $736.00 / $1,110.52
| Facility | | $497.99 | $736.00 | $1,110.52 |
- 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 |