- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $604.52 / $2,330.92 / $16,467.00
| Facility | | $604.52 | $2,330.92 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,213.23 / $4,657.84 / $7,666.70
| Facility | | $2,213.23 | $4,657.84 | $7,666.70 |
- 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
- $513.14 / $949.00 / $1,366.04
| Facility | | $513.14 | $949.00 | $1,366.04 |
- 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 |