- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $582.10 / $1,424.76 / $16,042.00
| Facility | | $582.10 | $1,424.76 | $16,042.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,209.00 / $10,300.00 / $16,615.00
| Facility | | $4,209.00 | $10,300.00 | $16,615.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $549.74 / $754.54 / $1,212.66
| Facility | | $549.74 | $754.54 | $1,212.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $689.98 / $865.00 / $2,258.41
| Facility | | $689.98 | $865.00 | $2,258.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,000.00 / $7,818.00 / $11,284.00
| Facility | | $2,000.00 | $7,818.00 | $11,284.00 |