- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $846.00 / $3,825.00 / $27,258.30
| Facility | | $846.00 | $3,825.00 | $27,258.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,581.22 / $1,581.22 / $2,572.84
| Facility | | $1,581.22 | $1,581.22 | $2,572.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,049.00 / $3,582.00 / $24,729.79
| Facility | | $1,049.00 | $3,582.00 | $24,729.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,783.67 / $21,352.47 / $34,665.32
| Facility | | $15,783.67 | $21,352.47 | $34,665.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,418.00 / $23,026.71 / $37,527.21
| Facility | | $1,418.00 | $23,026.71 | $37,527.21 |