- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $489.94 / $4,846.00 / $15,127.61
| Facility | | $489.94 | $4,846.00 | $15,127.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,309.00 / $6,474.00 / $13,758.00
| Facility | | $3,309.00 | $6,474.00 | $13,758.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $489.20 / $671.45 / $1,007.18
| Facility | | $489.20 | $671.45 | $1,007.18 |
- 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
- $3,932.00 / $8,348.00 / $12,569.00
| Facility | | $3,932.00 | $8,348.00 | $12,569.00 |