- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $385.18 / $2,382.21 / $14,063.00
| Facility | | $385.18 | $2,382.21 | $14,063.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,719.00 / $8,512.00 / $16,307.00
| Facility | | $3,719.00 | $8,512.00 | $16,307.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $398.70 / $562.88 / $844.32
| Facility | | $398.70 | $562.88 | $844.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,379.37 / $3,379.37 / $3,379.37
| Facility | | $3,379.37 | $3,379.37 | $3,379.37 |
- 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 |