- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $776.36 / $2,318.00 / $11,093.00
| Facility | | $776.36 | $2,318.00 | $11,093.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,140.00 / $5,948.00 / $9,462.00
| Facility | | $2,140.00 | $5,948.00 | $9,462.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $764.54 / $993.90 / $1,146.81
| Facility | | $764.54 | $993.90 | $1,146.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,239.56 / $1,239.56 / $1,469.38
| Facility | | $1,239.56 | $1,239.56 | $1,469.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,364.00 / $6,032.00 / $10,413.00
| Facility | | $3,364.00 | $6,032.00 | $10,413.00 |