- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $468.05 / $7,182.00 / $60,823.00
| Facility | | $468.05 | $7,182.00 | $60,823.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,090.27 / $3,663.21 / $6,467.30
| Facility | | $1,090.27 | $3,663.21 | $6,467.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,248.31 / $1,248.31 / $1,604.11
| Facility | | $1,248.31 | $1,248.31 | $1,604.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $357.89 / $538.26 / $791.93
| Facility | | $357.89 | $538.26 | $791.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,346.36 / $6,172.00 / $9,900.00
| Facility | | $1,346.36 | $6,172.00 | $9,900.00 |