- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $314.38 / $1,209.42 / $14,063.00
| Facility | | $314.38 | $1,209.42 | $14,063.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,146.00 / $9,219.00 / $30,900.00
| Facility | | $4,146.00 | $9,219.00 | $30,900.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $317.22 / $435.40 / $653.10
| Facility | | $317.22 | $435.40 | $653.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,705.12 / $4,705.12 / $5,577.46
| Facility | | $4,705.12 | $4,705.12 | $5,577.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,364.00 / $6,094.00 / $10,413.00
| Facility | | $3,364.00 | $6,094.00 | $10,413.00 |