- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $533.71 / $1,030.00 / $14,063.00
| Facility | | $533.71 | $1,030.00 | $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
- $537.04 / $737.13 / $1,105.70
| Facility | | $537.04 | $737.13 | $1,105.70 |
- 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
- $5,500.00 / $10,860.00 / $17,416.00
| Facility | | $5,500.00 | $10,860.00 | $17,416.00 |