- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $437.04 / $4,818.95 / $9,062.00
| Facility | | $437.04 | $4,818.95 | $9,062.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,706.68 / $7,533.12 / $13,582.15
| Facility | | $2,706.68 | $7,533.12 | $13,582.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $341.27 / $375.00 / $3,179.03
| Facility | | $341.27 | $375.00 | $3,179.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $403.01 / $524.45 / $774.53
| Facility | | $403.01 | $524.45 | $774.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,155.00 / $12,456.00 / $19,591.00
| Facility | | $2,155.00 | $12,456.00 | $19,591.00 |