- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $771.65 / $8,783.00 / $16,639.00
| Facility | | $771.65 | $8,783.00 | $16,639.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,040.75 / $11,405.05 / $20,652.61
| Facility | | $5,040.75 | $11,405.05 | $20,652.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $580.00 / $769.69 / $7,966.54
| Facility | | $580.00 | $769.69 | $7,966.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $744.37 / $964.03 / $1,450.41
| Facility | | $744.37 | $964.03 | $1,450.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,028.00 / $19,526.00 / $24,161.00
| Facility | | $3,028.00 | $19,526.00 | $24,161.00 |