- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $476.73 / $7,354.86 / $16,467.00
| Facility | | $476.73 | $7,354.86 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,165.67 / $5,853.24 / $10,114.27
| Facility | | $2,165.67 | $5,853.24 | $10,114.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,681.15 / $2,681.15 / $3,445.32
| Facility | | $2,681.15 | $2,681.15 | $3,445.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $405.22 / $558.00 / $870.10
| Facility | | $405.22 | $558.00 | $870.10 |
- 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 |