- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $312.98 / $8,716.00 / $16,467.00
| Facility | | $312.98 | $8,716.00 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,367.00 / $5,850.47 / $10,404.57
| Facility | | $2,367.00 | $5,850.47 | $10,404.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $375.00 / $615.00 / $5,812.94
| Facility | | $375.00 | $615.00 | $5,812.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $275.62 / $362.00 / $594.79
| Facility | | $275.62 | $362.00 | $594.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $870.00 / $12,269.00 / $19,591.00
| Facility | | $870.00 | $12,269.00 | $19,591.00 |