- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $647.10 / $5,866.00 / $16,467.00
| Facility | | $647.10 | $5,866.00 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,866.56 / $6,304.45 / $10,605.01
| Facility | | $2,866.56 | $6,304.45 | $10,605.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $505.00 / $675.90 / $5,740.31
| Facility | | $505.00 | $675.90 | $5,740.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $585.00 / $752.00 / $1,156.05
| Facility | | $585.00 | $752.00 | $1,156.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,550.00 / $10,878.00 / $16,901.00
| Facility | | $1,550.00 | $10,878.00 | $16,901.00 |