- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $410.07 / $901.00 / $7,278.00
| Facility | | $410.07 | $901.00 | $7,278.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,311.30 / $1,311.30 / $1,330.43
| Facility | | $1,311.30 | $1,311.30 | $1,330.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $530.04 / $530.04 / $2,062.80
| Facility | | $530.04 | $530.04 | $2,062.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $410.07 / $683.00 / $1,032.86
| Facility | | $410.07 | $683.00 | $1,032.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $900.00 / $3,733.00 / $6,543.00
| Facility | | $900.00 | $3,733.00 | $6,543.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,975.12 / $2,188.46 / $16,394.00
| Facility | | $1,975.12 | $2,188.46 | $16,394.00 |