- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $244.14 / $3,375.16 / $11,093.00
| Facility | | $244.14 | $3,375.16 | $11,093.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,309.00 / $6,278.00 / $10,837.00
| Facility | | $3,309.00 | $6,278.00 | $10,837.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $202.46 / $258.04 / $528.86
| Facility | | $202.46 | $258.04 | $528.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,243.79 / $2,243.79 / $2,243.79
| Facility | | $2,243.79 | $2,243.79 | $2,243.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,364.00 / $6,094.00 / $10,413.00
| Facility | | $3,364.00 | $6,094.00 | $10,413.00 |