- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $432.32 / $5,432.63 / $14,657.00
| Facility | | $432.32 | $5,432.63 | $14,657.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,990.00 / $9,565.00 / $11,253.00
| Facility | | $7,990.00 | $9,565.00 | $11,253.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $424.04 / $582.86 / $672.37
| Facility | | $424.04 | $582.86 | $672.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $766.05 / $766.05 / $766.05
| Facility | | $766.05 | $766.05 | $766.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $847.00 / $1,475.00 / $12,296.00
| Facility | | $847.00 | $1,475.00 | $12,296.00 |