- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $234.65 / $2,235.71 / $16,467.00
| Facility | | $234.65 | $2,235.71 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $861.74 / $2,501.06 / $4,619.54
| Facility | | $861.74 | $2,501.06 | $4,619.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,086.58 / $3,086.58 / $3,966.31
| Facility | | $3,086.58 | $3,086.58 | $3,966.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $234.65 / $545.36 / $1,517.09
| Facility | | $234.65 | $545.36 | $1,517.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,155.00 / $12,798.00 / $19,665.00
| Facility | | $2,155.00 | $12,798.00 | $19,665.00 |