- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $860.00 / $1,009.94 / $8,229.00
| Facility | | $860.00 | $1,009.94 | $8,229.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,062.90 / $9,987.00 / $21,322.13
| Facility | | $7,062.90 | $9,987.00 | $21,322.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $936.49 / $1,285.38 / $1,482.78
| Facility | | $936.49 | $1,285.38 | $1,482.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,026.59 / $1,133.74 / $1,133.74
| Facility | | $1,026.59 | $1,133.74 | $1,133.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $739.00 / $3,828.00 / $8,582.00
| Facility | | $739.00 | $3,828.00 | $8,582.00 |