- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $387.59 / $9,062.00 / $18,276.00
| Facility | | $387.59 | $9,062.00 | $18,276.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,251.80 / $5,867.32 / $10,114.27
| Facility | | $2,251.80 | $5,867.32 | $10,114.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $715.00 / $3,208.42 / $4,122.88
| Facility | | $715.00 | $3,208.42 | $4,122.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $312.44 / $436.18 / $748.34
| Facility | | $312.44 | $436.18 | $748.34 |
- 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 |