- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $625.30 / $1,338.00 / $10,661.00
| Facility | | $625.30 | $1,338.00 | $10,661.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $606.10 / $606.10 / $6,025.59
| Facility | | $606.10 | $606.10 | $6,025.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $625.30 / $894.18 / $1,413.20
| Facility | | $625.30 | $894.18 | $1,413.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,183.00 / $12,216.00 / $19,066.00
| Facility | | $3,183.00 | $12,216.00 | $19,066.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,396.52 / $19,913.50 / $26,542.00
| Facility | | $2,396.52 | $19,913.50 | $26,542.00 |