- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $860.00 / $1,232.46 / $9,311.00
| Facility | | $860.00 | $1,232.46 | $9,311.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,212.00 / $9,015.00 / $11,253.00
| Facility | | $7,212.00 | $9,015.00 | $11,253.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $991.16 / $1,360.42 / $1,569.34
| Facility | | $991.16 | $1,360.42 | $1,569.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,175.58 / $1,194.46 / $1,194.46
| Facility | | $1,175.58 | $1,194.46 | $1,194.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $842.00 / $4,539.00 / $10,113.00
| Facility | | $842.00 | $4,539.00 | $10,113.00 |