- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $442.96 / $5,866.00 / $16,467.00
| Facility | | $442.96 | $5,866.00 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,713.16 / $6,184.58 / $10,500.74
| Facility | | $2,713.16 | $6,184.58 | $10,500.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $457.54 / $505.00 / $2,581.96
| Facility | | $457.54 | $505.00 | $2,581.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $399.95 / $575.85 / $1,174.00
| Facility | | $399.95 | $575.85 | $1,174.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,550.00 / $10,257.00 / $16,249.00
| Facility | | $1,550.00 | $10,257.00 | $16,249.00 |