- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $343.96 / $7,362.57 / $16,467.00
| Facility | | $343.96 | $7,362.57 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,069.67 / $5,853.24 / $10,114.27
| Facility | | $2,069.67 | $5,853.24 | $10,114.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,106.17 / $2,106.17 / $2,706.47
| Facility | | $2,106.17 | $2,106.17 | $2,706.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $292.37 / $411.00 / $626.07
| Facility | | $292.37 | $411.00 | $626.07 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $569.26 / $616.50 / $798.51
| Facility | 50 | $569.26 | $616.50 | $798.51 |
- 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 |