- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,755.96 / $9,062.00 / $18,276.00
| Facility | | $1,755.96 | $9,062.00 | $18,276.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,335.21 / $6,740.14 / $11,552.91
| Facility | | $3,335.21 | $6,740.14 | $11,552.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $715.00 / $745.09 / $2,581.96
| Facility | | $715.00 | $745.09 | $2,581.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $731.60 / $871.00 / $1,456.00
| Facility | | $731.60 | $871.00 | $1,456.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,155.00 / $12,456.00 / $19,591.00
| Facility | | $2,155.00 | $12,456.00 | $19,591.00 |