- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $518.12 / $2,318.00 / $11,093.00
| Facility | | $518.12 | $2,318.00 | $11,093.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,309.00 / $6,474.00 / $13,810.27
| Facility | | $3,309.00 | $6,474.00 | $13,810.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $422.15 / $556.25 / $885.65
| Facility | | $422.15 | $556.25 | $885.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,129.11 / $2,129.11 / $2,129.11
| Facility | | $2,129.11 | $2,129.11 | $2,129.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,932.00 / $8,025.00 / $11,038.00
| Facility | | $3,932.00 | $8,025.00 | $11,038.00 |