- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $685.11 / $9,062.00 / $20,498.00
| Facility | | $685.11 | $9,062.00 | $20,498.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,335.21 / $7,069.60 / $11,780.16
| Facility | | $3,335.21 | $7,069.60 | $11,780.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $580.00 / $671.06 / $2,581.96
| Facility | | $580.00 | $671.06 | $2,581.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $671.54 / $865.90 / $1,405.42
| Facility | | $671.54 | $865.90 | $1,405.42 |
- 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 |