- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $940.78 / $8,876.00 / $16,467.00
| Facility | | $940.78 | $8,876.00 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,077.74 / $8,155.06 / $14,268.09
| Facility | | $3,077.74 | $8,155.06 | $14,268.09 |
- 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
- $741.74 / $977.00 / $1,611.32
| Facility | | $741.74 | $977.00 | $1,611.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,155.00 / $12,798.00 / $19,665.00
| Facility | | $2,155.00 | $12,798.00 | $19,665.00 |