- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $672.17 / $10,341.00 / $21,210.90
| Facility | | $672.17 | $10,341.00 | $21,210.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,313.90 / $6,926.74 / $11,667.62
| Facility | | $3,313.90 | $6,926.74 | $11,667.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $580.00 / $670.69 / $5,740.31
| Facility | | $580.00 | $670.69 | $5,740.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $640.91 / $806.60 / $1,256.82
| Facility | | $640.91 | $806.60 | $1,256.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,028.00 / $19,526.00 / $24,161.00
| Facility | | $3,028.00 | $19,526.00 | $24,161.00 |