- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $504.34 / $1,338.00 / $8,413.00
| Facility | | $504.34 | $1,338.00 | $8,413.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $506.60 / $4,773.45 / $9,490.07
| Facility | | $506.60 | $4,773.45 | $9,490.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $503.08 / $642.53 / $932.83
| Facility | | $503.08 | $642.53 | $932.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,717.00 / $2,500.00 / $18,665.00
| Facility | | $1,717.00 | $2,500.00 | $18,665.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,037.15 / $26,542.00 / $27,770.10
| Facility | | $2,037.15 | $26,542.00 | $27,770.10 |