- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $441.23 / $4,846.00 / $19,071.00
| Facility | | $441.23 | $4,846.00 | $19,071.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,683.00 / $11,305.00 / $30,091.00
| Facility | | $1,683.00 | $11,305.00 | $30,091.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $407.75 / $530.08 / $7,052.97
| Facility | | $407.75 | $530.08 | $7,052.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $761.00 / $766.05 / $9,589.64
| Facility | | $761.00 | $766.05 | $9,589.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,300.00 / $11,200.00 / $17,416.00
| Facility | | $3,300.00 | $11,200.00 | $17,416.00 |