- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $118.68 / $1,386.00 / $7,954.00
| Facility | | $118.68 | $1,386.00 | $7,954.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,682.00 / $3,950.00 / $13,758.00
| Facility | | $1,682.00 | $3,950.00 | $13,758.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $208.76 / $271.39 / $448.13
| Facility | | $208.76 | $271.39 | $448.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,320.43 / $3,320.43 / $3,936.05
| Facility | | $3,320.43 | $3,320.43 | $3,936.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,882.11 / $7,672.00 / $12,569.00
| Facility | | $2,882.11 | $7,672.00 | $12,569.00 |