- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $615.11 / $11,032.00 / $19,696.93
| Facility | | $615.11 | $11,032.00 | $19,696.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,313.90 / $6,926.74 / $11,667.62
| Facility | | $3,313.90 | $6,926.74 | $11,667.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $580.00 / $612.28 / $2,581.96
| Facility | | $580.00 | $612.28 | $2,581.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $591.48 / $762.33 / $1,307.10
| Facility | | $591.48 | $762.33 | $1,307.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,500.00 / $13,190.00 / $19,665.00
| Facility | | $2,500.00 | $13,190.00 | $19,665.00 |