- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $604.79 / $2,294.73 / $16,042.00
| Facility | | $604.79 | $2,294.73 | $16,042.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,719.00 / $10,700.00 / $17,513.00
| Facility | | $3,719.00 | $10,700.00 | $17,513.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $566.22 / $721.66 / $832.68
| Facility | | $566.22 | $721.66 | $832.68 |
- 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
- $3,932.00 / $8,025.00 / $11,038.00
| Facility | | $3,932.00 | $8,025.00 | $11,038.00 |