- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $410.36 / $9,062.00 / $14,644.00
| Facility | | $410.36 | $9,062.00 | $14,644.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,547.21 / $5,475.43 / $10,970.79
| Facility | | $2,547.21 | $5,475.43 | $10,970.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $815.00 / $3,086.58 / $3,966.31
| Facility | | $815.00 | $3,086.58 | $3,966.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $344.13 / $513.17 / $819.48
| Facility | | $344.13 | $513.17 | $819.48 |
- 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 |