- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $471.41 / $4,846.00 / $14,063.00
| Facility | | $471.41 | $4,846.00 | $14,063.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,754.00 / $6,818.00 / $11,598.00
| Facility | | $2,754.00 | $6,818.00 | $11,598.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $437.66 / $568.96 / $656.49
| Facility | | $437.66 | $568.96 | $656.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $545.70 / $761.00 / $1,873.52
| Facility | | $545.70 | $761.00 | $1,873.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,500.00 / $5,995.00 / $9,243.00
| Facility | | $1,500.00 | $5,995.00 | $9,243.00 |