- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $647.24 / $2,278.75 / $14,063.00
| Facility | | $647.24 | $2,278.75 | $14,063.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,641.00 / $8,512.00 / $16,307.00
| Facility | | $3,641.00 | $8,512.00 | $16,307.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $673.50 / $887.43 / $1,331.15
| Facility | | $673.50 | $887.43 | $1,331.15 |
- 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
- $3,932.00 / $8,348.00 / $12,569.00
| Facility | | $3,932.00 | $8,348.00 | $12,569.00 |