- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $787.64 / $9,062.00 / $18,276.00
| Facility | | $787.64 | $9,062.00 | $18,276.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,073.24 / $5,808.35 / $9,670.36
| Facility | | $3,073.24 | $5,808.35 | $9,670.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $715.00 / $715.00 / $1,985.43
| Facility | | $715.00 | $715.00 | $1,985.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.00 / $724.26 / $1,109.85
| Facility | | $524.00 | $724.26 | $1,109.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,258.00 / $10,257.00 / $16,249.00
| Facility | | $1,258.00 | $10,257.00 | $16,249.00 |