- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $423.52 / $6,227.83 / $30,829.00
| Facility | | $423.52 | $6,227.83 | $30,829.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,187.00 / $5,636.89 / $9,721.67
| Facility | | $2,187.00 | $5,636.89 | $9,721.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,021.41 / $2,021.41 / $2,597.55
| Facility | | $2,021.41 | $2,021.41 | $2,597.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $307.74 / $465.87 / $689.15
| Facility | | $307.74 | $465.87 | $689.15 |
- 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 |