- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $966.02 / $2,482.67 / $16,042.00
| Facility | | $966.02 | $2,482.67 | $16,042.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,646.00 / $20,160.00 / $44,379.00
| Facility | | $1,646.00 | $20,160.00 | $44,379.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $938.38 / $1,219.89 / $1,407.57
| Facility | | $938.38 | $1,219.89 | $1,407.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $865.00 / $865.00 / $1,205.45
| Facility | | $865.00 | $865.00 | $1,205.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,300.00 / $11,200.00 / $17,416.00
| Facility | | $3,300.00 | $11,200.00 | $17,416.00 |