- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.22 / $9,062.00 / $20,498.00
| Facility | | $575.22 | $9,062.00 | $20,498.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,357.47 / $7,069.60 / $11,667.62
| Facility | | $3,357.47 | $7,069.60 | $11,667.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.09 / $580.00 / $2,581.96
| Facility | | $575.09 | $580.00 | $2,581.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $555.08 / $699.44 / $1,088.96
| Facility | | $555.08 | $699.44 | $1,088.96 |
- 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 |