- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.60 / $2,318.00 / $11,093.00
| Facility | | $630.60 | $2,318.00 | $11,093.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,473.00 / $7,890.00 / $30,900.00
| Facility | | $3,473.00 | $7,890.00 | $30,900.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $629.52 / $864.05 / $1,296.08
| Facility | | $629.52 | $864.05 | $1,296.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,529.88 / $6,529.88 / $7,740.54
| Facility | | $6,529.88 | $6,529.88 | $7,740.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,058.00 / $12,330.00 / $17,416.00
| Facility | | $5,058.00 | $12,330.00 | $17,416.00 |