- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $920.81 / $8,783.00 / $16,639.00
| Facility | | $920.81 | $8,783.00 | $16,639.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,574.76 / $9,263.14 / $15,459.94
| Facility | | $4,574.76 | $9,263.14 | $15,459.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $580.00 / $580.00 / $2,594.85
| Facility | | $580.00 | $580.00 | $2,594.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $632.00 / $871.00 / $1,234.47
| Facility | | $632.00 | $871.00 | $1,234.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,114.00 / $12,271.00 / $22,523.00
| Facility | | $5,114.00 | $12,271.00 | $22,523.00 |