- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $578.86 / $6,065.28 / $14,063.00
| Facility | | $578.86 | $6,065.28 | $14,063.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,536.00 / $7,833.00 / $14,645.00
| Facility | | $3,536.00 | $7,833.00 | $14,645.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $577.51 / $792.67 / $1,189.01
| Facility | | $577.51 | $792.67 | $1,189.01 |
- 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 |