- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $516.66 / $5,752.00 / $10,439.00
| Facility | | $516.66 | $5,752.00 | $10,439.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,635.01 / $2,940.60 / $3,611.27
| Facility | | $1,635.01 | $2,940.60 | $3,611.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,284.00 / $1,464.00 / $1,741.00
| Facility | | $1,284.00 | $1,464.00 | $1,741.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $313.95 / $450.88 / $4,201.00
| Facility | | $313.95 | $450.88 | $4,201.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,037.00 / $3,096.00 / $5,562.00
| Facility | | $1,037.00 | $3,096.00 | $5,562.00 |