- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $333.49 / $5,866.00 / $13,217.84
| Facility | | $333.49 | $5,866.00 | $13,217.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,435.23 / $6,151.53 / $10,789.39
| Facility | | $2,435.23 | $6,151.53 | $10,789.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $505.00 / $2,021.41 / $2,597.55
| Facility | | $505.00 | $2,021.41 | $2,597.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $254.89 / $393.72 / $570.75
| Facility | | $254.89 | $393.72 | $570.75 |
- 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 |