- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $412.25 / $1,600.57 / $11,093.00
| Facility | | $412.25 | $1,600.57 | $11,093.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,497.00 / $9,644.00 / $15,154.00
| Facility | | $3,497.00 | $9,644.00 | $15,154.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $417.49 / $573.02 / $859.53
| Facility | | $417.49 | $573.02 | $859.53 |
- 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
- $3,364.00 / $6,032.00 / $10,413.00
| Facility | | $3,364.00 | $6,032.00 | $10,413.00 |