- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $332.88 / $4,117.22 / $14,099.57
| Facility | | $332.88 | $4,117.22 | $14,099.57 |
- 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
- $716.43 / $913.09 / $1,053.57
| Facility | | $716.43 | $913.09 | $1,053.57 |
- 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 |