- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $227.67 / $2,318.00 / $16,042.00
| Facility | | $227.67 | $2,318.00 | $16,042.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,536.00 / $10,284.00 / $16,778.00
| Facility | | $3,536.00 | $10,284.00 | $16,778.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $244.13 / $332.91 / $499.37
| Facility | | $244.13 | $332.91 | $499.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,218.40 / $2,218.40 / $2,218.40
| Facility | | $2,218.40 | $2,218.40 | $2,218.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,364.00 / $6,094.00 / $10,413.00
| Facility | | $3,364.00 | $6,094.00 | $10,413.00 |