- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $703.02 / $1,615.00 / $10,768.00
| Facility | | $703.02 | $1,615.00 | $10,768.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,403.26 / $4,403.26 / $4,467.51
| Facility | | $4,403.26 | $4,403.26 | $4,467.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $748.70 / $748.70 / $6,025.59
| Facility | | $748.70 | $748.70 | $6,025.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $703.02 / $885.50 / $1,437.61
| Facility | | $703.02 | $885.50 | $1,437.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,317.00 / $14,893.00 / $22,265.00
| Facility | | $4,317.00 | $14,893.00 | $22,265.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,263.35 / $19,913.50 / $26,542.00
| Facility | | $3,263.35 | $19,913.50 | $26,542.00 |