- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $225.23 / $5,866.00 / $16,467.00
| Facility | | $225.23 | $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
- $222.44 / $505.00 / $1,512.28
| Facility | | $222.44 | $505.00 | $1,512.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $212.29 / $270.27 / $430.09
| Facility | | $212.29 | $270.27 | $430.09 |
- 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 |