- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $368.33 / $1,386.00 / $7,212.00
| Facility | | $368.33 | $1,386.00 | $7,212.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,266.00 / $5,570.00 / $19,484.00
| Facility | | $2,266.00 | $5,570.00 | $19,484.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $359.93 / $467.91 / $512.21
| Facility | | $359.93 | $467.91 | $512.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,744.67 / $5,744.67 / $6,809.74
| Facility | | $5,744.67 | $5,744.67 | $6,809.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,472.00 / $10,113.00 / $15,750.00
| Facility | | $4,472.00 | $10,113.00 | $15,750.00 |