- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $645.72 / $2,318.00 / $16,042.00
| Facility | | $645.72 | $2,318.00 | $16,042.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,239.00 / $12,289.00 / $37,919.46
| Facility | | $3,239.00 | $12,289.00 | $37,919.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $643.21 / $882.84 / $1,324.26
| Facility | | $643.21 | $882.84 | $1,324.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,578.35 / $13,578.35 / $16,095.80
| Facility | | $13,578.35 | $13,578.35 | $16,095.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,431.00 / $11,803.02 / $17,416.00
| Facility | | $5,431.00 | $11,803.02 | $17,416.00 |