- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $412.29 / $5,495.86 / $16,467.00
| Facility | | $412.29 | $5,495.86 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,111.52 / $7,927.21 / $13,640.30
| Facility | | $3,111.52 | $7,927.21 | $13,640.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $580.00 / $2,831.77 / $3,638.88
| Facility | | $580.00 | $2,831.77 | $3,638.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $351.35 / $453.52 / $807.18
| Facility | | $351.35 | $453.52 | $807.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,764.00 / $10,147.00 / $16,816.00
| Facility | | $2,764.00 | $10,147.00 | $16,816.00 |