- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $989.60 / $1,528.37 / $14,063.00
| Facility | | $989.60 | $1,528.37 | $14,063.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,641.00 / $8,512.00 / $16,305.00
| Facility | | $3,641.00 | $8,512.00 | $16,305.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $922.45 / $1,175.67 / $1,356.54
| Facility | | $922.45 | $1,175.67 | $1,356.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $761.00 / $1,121.54 / $3,909.74
| Facility | | $761.00 | $1,121.54 | $3,909.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,500.00 / $5,995.00 / $9,243.00
| Facility | | $1,500.00 | $5,995.00 | $9,243.00 |