- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $573.57 / $1,391.00 / $14,063.00
| Facility | | $573.57 | $1,391.00 | $14,063.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,807.00 / $7,833.00 / $14,645.00
| Facility | | $2,807.00 | $7,833.00 | $14,645.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $534.16 / $694.41 / $801.24
| Facility | | $534.16 | $694.41 | $801.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.44 / $761.00 / $2,258.41
| Facility | | $676.44 | $761.00 | $2,258.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,029.00 / $7,830.00 / $11,284.00
| Facility | | $2,029.00 | $7,830.00 | $11,284.00 |