- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $768.11 / $5,467.00 / $12,237.00
| Facility | | $768.11 | $5,467.00 | $12,237.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,461.10 / $2,715.15 / $4,532.06
| Facility | | $1,461.10 | $2,715.15 | $4,532.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $624.00 / $624.00 / $624.00
| Facility | | $624.00 | $624.00 | $624.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $425.81 / $769.31 / $3,561.00
| Facility | | $425.81 | $769.31 | $3,561.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,436.00 / $3,096.00 / $5,565.00
| Facility | | $1,436.00 | $3,096.00 | $5,565.00 |