- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $529.04 / $6,548.00 / $16,467.00
| Facility | | $529.04 | $6,548.00 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,061.00 / $5,797.05 / $11,630.37
| Facility | | $1,061.00 | $5,797.05 | $11,630.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $375.00 / $655.00 / $6,454.10
| Facility | | $375.00 | $655.00 | $6,454.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $499.63 / $655.64 / $1,024.85
| Facility | | $499.63 | $655.64 | $1,024.85 |
- 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 |