- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $886.46 / $9,062.00 / $17,247.00
| Facility | | $886.46 | $9,062.00 | $17,247.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,789.01 / $5,779.34 / $10,022.01
| Facility | | $2,789.01 | $5,779.34 | $10,022.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,130.00 / $1,774.26 / $2,279.96
| Facility | | $1,130.00 | $1,774.26 | $2,279.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $763.21 / $975.11 / $1,740.95
| Facility | | $763.21 | $975.11 | $1,740.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $791.00 / $10,257.00 / $16,249.00
| Facility | | $791.00 | $10,257.00 | $16,249.00 |