- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $345.76 / $5,866.00 / $16,467.00
| Facility | | $345.76 | $5,866.00 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,808.51 / $8,269.29 / $14,361.26
| Facility | | $3,808.51 | $8,269.29 | $14,361.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $338.88 / $505.00 / $5,051.60
| Facility | | $338.88 | $505.00 | $5,051.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $332.29 / $465.20 / $649.71
| Facility | | $332.29 | $465.20 | $649.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,028.00 / $19,526.00 / $24,161.00
| Facility | | $3,028.00 | $19,526.00 | $24,161.00 |