- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $577.36 / $5,866.00 / $16,467.00
| Facility | | $577.36 | $5,866.00 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,715.67 / $4,408.50 / $7,418.57
| Facility | | $1,715.67 | $4,408.50 | $7,418.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $505.00 / $553.94 / $1,512.28
| Facility | | $505.00 | $553.94 | $1,512.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.16 / $644.00 / $1,075.99
| Facility | | $537.16 | $644.00 | $1,075.99 |
- 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 |