- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $380.73 / $1,030.00 / $14,063.00
| Facility | | $380.73 | $1,030.00 | $14,063.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,146.00 / $9,219.00 / $30,900.00
| Facility | | $4,146.00 | $9,219.00 | $30,900.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $382.03 / $524.36 / $786.54
| Facility | | $382.03 | $524.36 | $786.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,705.12 / $4,705.12 / $5,577.46
| Facility | | $4,705.12 | $4,705.12 | $5,577.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,364.00 / $6,032.00 / $10,769.00
| Facility | | $3,364.00 | $6,032.00 | $10,769.00 |