- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $680.22 / $5,866.00 / $16,467.00
| Facility | | $680.22 | $5,866.00 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,954.85 / $4,452.39 / $7,418.57
| Facility | | $1,954.85 | $4,452.39 | $7,418.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $505.00 / $689.29 / $1,512.28
| Facility | | $505.00 | $689.29 | $1,512.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $651.16 / $772.00 / $1,303.24
| Facility | | $651.16 | $772.00 | $1,303.24 |
- 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 |