- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $353.48 / $2,318.00 / $14,063.00
| Facility | | $353.48 | $2,318.00 | $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
- $344.96 / $487.01 / $730.52
| Facility | | $344.96 | $487.01 | $730.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,158.09 / $2,158.09 / $2,158.09
| Facility | | $2,158.09 | $2,158.09 | $2,158.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,253.00 / $6,434.00 / $10,413.00
| Facility | | $3,253.00 | $6,434.00 | $10,413.00 |