- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $673.91 / $9,062.00 / $20,498.00
| Facility | | $673.91 | $9,062.00 | $20,498.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,313.90 / $6,940.43 / $11,667.62
| Facility | | $3,313.90 | $6,940.43 | $11,667.62 |
- 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
- $635.03 / $806.41 / $1,265.86
| Facility | | $635.03 | $806.41 | $1,265.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,114.00 / $12,271.00 / $22,523.00
| Facility | | $5,114.00 | $12,271.00 | $22,523.00 |