- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $133.28 / $5,621.00 / $9,727.00
| Facility | | $133.28 | $5,621.00 | $9,727.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,053.78 / $7,464.41 / $12,582.34
| Facility | | $3,053.78 | $7,464.41 | $12,582.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,200.39 / $3,200.39 / $4,112.56
| Facility | | $3,200.39 | $3,200.39 | $4,112.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.16 / $957.19 / $2,268.98
| Facility | | $100.16 | $957.19 | $2,268.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,298.00 / $15,713.00 / $23,485.00
| Facility | | $6,298.00 | $15,713.00 | $23,485.00 |