- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $505.01 / $2,598.00 / $12,154.00
| Facility | | $505.01 | $2,598.00 | $12,154.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $902.00 / $6,799.00 / $40,323.00
| Facility | | $902.00 | $6,799.00 | $40,323.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,083.00 / $10,223.00 / $15,638.00
| Facility | | $1,083.00 | $10,223.00 | $15,638.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $327.87 / $560.28 / $10,837.41
| Facility | | $327.87 | $560.28 | $10,837.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,748.00 / $4,449.00 / $9,475.00
| Facility | | $1,748.00 | $4,449.00 | $9,475.00 |