- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $606.53 / $9,062.00 / $18,276.00
| Facility | | $606.53 | $9,062.00 | $18,276.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,160.92 / $4,890.35 / $7,789.04
| Facility | | $2,160.92 | $4,890.35 | $7,789.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $600.91 / $600.91 / $890.00
| Facility | | $600.91 | $600.91 | $890.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $586.53 / $778.01 / $1,173.59
| Facility | | $586.53 | $778.01 | $1,173.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,155.00 / $12,456.00 / $19,591.00
| Facility | | $2,155.00 | $12,456.00 | $19,591.00 |