- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $473.01 / $1,556.77 / $16,467.00
| Facility | | $473.01 | $1,556.77 | $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
- $580.00 / $703.52 / $2,581.96
| Facility | | $580.00 | $703.52 | $2,581.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $412.54 / $652.46 / $1,063.21
| Facility | | $412.54 | $652.46 | $1,063.21 |
- 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 |