- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $479.37 / $5,621.00 / $9,870.00
| Facility | | $479.37 | $5,621.00 | $9,870.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,715.67 / $4,227.60 / $7,360.51
| Facility | | $1,715.67 | $4,227.60 | $7,360.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.59 / $505.00 / $1,512.28
| Facility | | $467.59 | $505.00 | $1,512.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $444.59 / $546.00 / $881.53
| Facility | | $444.59 | $546.00 | $881.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,981.00 / $10,147.00 / $16,816.00
| Facility | | $1,981.00 | $10,147.00 | $16,816.00 |