- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $650.48 / $2,159.98 / $16,467.00
| Facility | | $650.48 | $2,159.98 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,813.91 / $11,405.05 / $20,652.61
| Facility | | $4,813.91 | $11,405.05 | $20,652.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $715.00 / $975.22 / $5,740.31
| Facility | | $715.00 | $975.22 | $5,740.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $649.30 / $922.96 / $1,468.63
| Facility | | $649.30 | $922.96 | $1,468.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,628.00 / $17,146.00 / $24,161.00
| Facility | | $4,628.00 | $17,146.00 | $24,161.00 |