- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $843.26 / $1,061.39 / $10,152.00
| Facility | | $843.26 | $1,061.39 | $10,152.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,062.90 / $9,565.00 / $21,322.13
| Facility | | $7,062.90 | $9,565.00 | $21,322.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $914.10 / $1,250.68 / $1,442.75
| Facility | | $914.10 | $1,250.68 | $1,442.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $985.82 / $1,103.26 / $1,103.26
| Facility | | $985.82 | $1,103.26 | $1,103.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $599.00 / $2,723.00 / $6,295.00
| Facility | | $599.00 | $2,723.00 | $6,295.00 |