- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $547.61 / $1,407.36 / $11,093.00
| Facility | | $547.61 | $1,407.36 | $11,093.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,473.00 / $6,474.00 / $13,758.00
| Facility | | $3,473.00 | $6,474.00 | $13,758.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $568.60 / $749.21 / $1,123.82
| Facility | | $568.60 | $749.21 | $1,123.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,116.34 / $2,116.34 / $2,508.71
| Facility | | $2,116.34 | $2,116.34 | $2,508.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,719.19 / $10,860.00 / $17,416.00
| Facility | | $2,719.19 | $10,860.00 | $17,416.00 |