- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $682.08 / $3,787.19 / $10,661.95
| Facility | | $682.08 | $3,787.19 | $10,661.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,239.00 / $10,444.00 / $37,919.46
| Facility | | $3,239.00 | $10,444.00 | $37,919.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.42 / $928.42 / $1,392.63
| Facility | | $676.42 | $928.42 | $1,392.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,207.88 / $13,207.88 / $15,656.65
| Facility | | $13,207.88 | $13,207.88 | $15,656.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,431.00 / $12,330.00 / $17,649.00
| Facility | | $5,431.00 | $12,330.00 | $17,649.00 |