- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $560.41 / $3,776.00 / $9,727.00
| Facility | | $560.41 | $3,776.00 | $9,727.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,651.64 / $3,647.71 / $7,044.49
| Facility | | $1,651.64 | $3,647.71 | $7,044.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $375.00 / $580.00 / $1,512.28
| Facility | | $375.00 | $580.00 | $1,512.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $539.26 / $855.68 / $1,434.57
| Facility | | $539.26 | $855.68 | $1,434.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,550.00 / $10,257.00 / $16,249.00
| Facility | | $1,550.00 | $10,257.00 | $16,249.00 |