- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $531.39 / $9,062.00 / $21,886.00
| Facility | | $531.39 | $9,062.00 | $21,886.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,545.00 / $3,838.81 / $13,344.69
| Facility | | $1,545.00 | $3,838.81 | $13,344.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $375.00 / $766.05 / $9,432.71
| Facility | | $375.00 | $766.05 | $9,432.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $505.10 / $6,916.51 / $11,493.81
| Facility | | $505.10 | $6,916.51 | $11,493.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,250.00 / $17,146.00 / $24,161.00
| Facility | | $1,250.00 | $17,146.00 | $24,161.00 |