- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $966.42 / $1,234.33 / $9,311.00
| Facility | | $966.42 | $1,234.33 | $9,311.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,237.97 / $9,463.93 / $15,812.91
| Facility | | $5,237.97 | $9,463.93 | $15,812.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $944.76 / $1,296.72 / $1,495.87
| Facility | | $944.76 | $1,296.72 | $1,495.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,140.74 / $1,140.74 / $1,140.74
| Facility | | $1,140.74 | $1,140.74 | $1,140.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $631.00 / $1,243.96 / $8,582.00
| Facility | | $631.00 | $1,243.96 | $8,582.00 |