- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $606.26 / $8,089.89 / $19,089.00
| Facility | | $606.26 | $8,089.89 | $19,089.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,335.21 / $7,093.82 / $11,667.62
| Facility | | $3,335.21 | $7,093.82 | $11,667.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $580.00 / $596.91 / $2,581.96
| Facility | | $580.00 | $596.91 | $2,581.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $590.08 / $731.31 / $1,152.92
| Facility | | $590.08 | $731.31 | $1,152.92 |
- 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 |