- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.36 / $5,020.18 / $12,806.58
| Facility | | $501.36 | $5,020.18 | $12,806.58 |
- 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
- $502.10 / $689.15 / $1,033.73
| Facility | | $502.10 | $689.15 | $1,033.73 |
- 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 |