- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $344.47 / $3,584.04 / $5,634.00
| Facility | | $344.47 | $3,584.04 | $5,634.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,682.00 / $3,950.00 / $16,615.00
| Facility | | $1,682.00 | $3,950.00 | $16,615.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $268.52 / $349.08 / $384.41
| Facility | | $268.52 | $349.08 | $384.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,605.73 / $2,605.73 / $3,088.84
| Facility | | $2,605.73 | $2,605.73 | $3,088.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,932.00 / $8,582.00 / $12,569.00
| Facility | | $3,932.00 | $8,582.00 | $12,569.00 |