- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $270.27 / $5,621.00 / $9,870.00
| Facility | | $270.27 | $5,621.00 | $9,870.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,708.04 / $5,756.96 / $9,923.85
| Facility | | $1,708.04 | $5,756.96 | $9,923.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $505.00 / $3,086.58 / $3,966.31
| Facility | | $505.00 | $3,086.58 | $3,966.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $235.61 / $349.56 / $507.00
| Facility | | $235.61 | $349.56 | $507.00 |
- 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 |