- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $418.58 / $2,652.00 / $7,602.00
| Facility | | $418.58 | $2,652.00 | $7,602.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,676.00 / $3,611.00 / $5,737.00
| Facility | | $1,676.00 | $3,611.00 | $5,737.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.00 / $30.00 / $30.00
| Facility | | $30.00 | $30.00 | $30.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,550.58 / $1,577.40 / $26,542.00
| Facility | | $1,550.58 | $1,577.40 | $26,542.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,794.00 / $3,626.00 / $6,291.00
| Facility | | $1,794.00 | $3,626.00 | $6,291.00 |