- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $290.33 / $8,876.00 / $16,467.00
| Facility | | $290.33 | $8,876.00 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,884.61 / $5,062.47 / $9,210.43
| Facility | | $1,884.61 | $5,062.47 | $9,210.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $580.00 / $2,048.92 / $2,632.90
| Facility | | $580.00 | $2,048.92 | $2,632.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $245.64 / $367.21 / $579.03
| Facility | | $245.64 | $367.21 | $579.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $791.00 / $10,257.00 / $16,249.00
| Facility | | $791.00 | $10,257.00 | $16,249.00 |