- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $417.54 / $4,596.08 / $7,616.00
| Facility | | $417.54 | $4,596.08 | $7,616.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,114.00 / $3,832.00 / $9,663.00
| Facility | | $2,114.00 | $3,832.00 | $9,663.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,559.00 / $6,120.00 / $8,538.00
| Facility | | $3,559.00 | $6,120.00 | $8,538.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $284.61 / $462.45 / $3,532.00
| Facility | | $284.61 | $462.45 | $3,532.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,694.00 / $3,018.00 / $5,813.00
| Facility | | $1,694.00 | $3,018.00 | $5,813.00 |