- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $277.11 / $2,309.71 / $9,727.00
| Facility | | $277.11 | $2,309.71 | $9,727.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,502.93 / $4,476.82 / $7,491.34
| Facility | | $1,502.93 | $4,476.82 | $7,491.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,221.33 / $1,221.33 / $1,569.43
| Facility | | $1,221.33 | $1,221.33 | $1,569.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $277.11 / $1,039.59 / $1,909.48
| Facility | | $277.11 | $1,039.59 | $1,909.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $791.00 / $10,257.00 / $16,249.00
| Facility | | $791.00 | $10,257.00 | $16,249.00 |