- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $832.73 / $9,622.00 / $18,276.00
| Facility | | $832.73 | $9,622.00 | $18,276.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,170.88 / $5,946.03 / $9,876.36
| Facility | | $3,170.88 | $5,946.03 | $9,876.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,677.54 / $1,677.54 / $1,677.54
| Facility | | $1,677.54 | $1,677.54 | $1,677.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $553.00 / $761.19 / $1,169.18
| Facility | | $553.00 | $761.19 | $1,169.18 |
- 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 |