- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $495.36 / $1,634.67 / $16,467.00
| Facility | | $495.36 | $1,634.67 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,001.95 / $5,044.83 / $8,588.78
| Facility | | $2,001.95 | $5,044.83 | $8,588.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $580.00 / $739.66 / $7,736.25
| Facility | | $580.00 | $739.66 | $7,736.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $495.36 / $749.60 / $1,138.25
| Facility | | $495.36 | $749.60 | $1,138.25 |
- 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 |