- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616.70 / $1,391.00 / $14,063.00
| Facility | | $616.70 | $1,391.00 | $14,063.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,153.00 / $9,200.00 / $16,778.00
| Facility | | $1,153.00 | $9,200.00 | $16,778.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $580.98 / $740.47 / $854.39
| Facility | | $580.98 | $740.47 | $854.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $732.65 / $732.65 / $761.00
| Facility | | $732.65 | $732.65 | $761.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,029.00 / $7,830.00 / $11,284.00
| Facility | | $2,029.00 | $7,830.00 | $11,284.00 |