- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $656.37 / $1,494.00 / $10,985.00
| Facility | | $656.37 | $1,494.00 | $10,985.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,601.00 / $8,240.00 / $17,829.00
| Facility | | $3,601.00 | $8,240.00 | $17,829.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $615.74 / $784.77 / $905.51
| Facility | | $615.74 | $784.77 | $905.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,243.79 / $2,243.79 / $2,243.79
| Facility | | $2,243.79 | $2,243.79 | $2,243.79 |
- 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 |