- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $974.66 / $1,775.95 / $14,536.00
| Facility | | $974.66 | $1,775.95 | $14,536.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,496.00 / $47,355.00 / $52,617.00
| Facility | | $9,496.00 | $47,355.00 | $52,617.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $908.78 / $1,240.47 / $1,430.97
| Facility | | $908.78 | $1,240.47 | $1,430.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,093.21 / $1,093.21 / $1,243.28
| Facility | | $1,093.21 | $1,093.21 | $1,243.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,666.00 / $8,525.00 / $33,259.00
| Facility | | $1,666.00 | $8,525.00 | $33,259.00 |