- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $539.46 / $9,062.00 / $16,467.00
| Facility | | $539.46 | $9,062.00 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,133.92 / $5,551.01 / $9,227.19
| Facility | | $2,133.92 | $5,551.01 | $9,227.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $580.00 / $2,106.17 / $2,706.47
| Facility | | $580.00 | $2,106.17 | $2,706.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $425.97 / $567.39 / $924.23
| Facility | | $425.97 | $567.39 | $924.23 |
- 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 |