- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $345.93 / $9,906.62 / $18,844.90
| Facility | | $345.93 | $9,906.62 | $18,844.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,536.00 / $7,833.00 / $14,645.00
| Facility | | $3,536.00 | $7,833.00 | $14,645.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $343.18 / $484.49 / $726.74
| Facility | | $343.18 | $484.49 | $726.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,218.40 / $2,218.40 / $2,218.40
| Facility | | $2,218.40 | $2,218.40 | $2,218.40 |
- 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 |