- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $431.64 / $1,386.00 / $14,063.00
| Facility | | $431.64 | $1,386.00 | $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
- $446.79 / $630.77 / $946.16
| Facility | | $446.79 | $630.77 | $946.16 |
- 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 / $5,174.00 / $9,243.00
| Facility | | $3,364.00 | $5,174.00 | $9,243.00 |