- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $341.49 / $1,386.00 / $11,093.00
| Facility | | $341.49 | $1,386.00 | $11,093.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,473.00 / $7,200.00 / $15,727.00
| Facility | | $3,473.00 | $7,200.00 | $15,727.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $319.75 / $407.52 / $470.22
| Facility | | $319.75 | $407.52 | $470.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,982.66 / $2,982.66 / $2,982.66
| Facility | | $2,982.66 | $2,982.66 | $2,982.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,137.06 / $9,369.00 / $15,660.00
| Facility | | $4,137.06 | $9,369.00 | $15,660.00 |