- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $495.61 / $3,697.00 / $8,084.00
| Facility | | $495.61 | $3,697.00 | $8,084.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,232.00 / $4,286.00 / $9,663.00
| Facility | | $2,232.00 | $4,286.00 | $9,663.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,231.00 / $9,308.00 / $10,577.00
| Facility | | $6,231.00 | $9,308.00 | $10,577.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $343.57 / $564.13 / $2,680.00
| Facility | | $343.57 | $564.13 | $2,680.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,438.00 / $2,959.00 / $5,813.00
| Facility | | $1,438.00 | $2,959.00 | $5,813.00 |