- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $554.37 / $1,181.00 / $7,278.00
| Facility | | $554.37 | $1,181.00 | $7,278.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $530.04 / $530.04 / $8,642.16
| Facility | | $530.04 | $530.04 | $8,642.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $643.86 / $949.00 / $1,519.51
| Facility | | $643.86 | $949.00 | $1,519.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,015.00 / $15,545.00 / $22,780.00
| Facility | | $4,015.00 | $15,545.00 | $22,780.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,006.52 / $3,302.06 / $16,394.00
| Facility | | $3,006.52 | $3,302.06 | $16,394.00 |