- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616.19 / $968.03 / $7,278.00
| Facility | | $616.19 | $968.03 | $7,278.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,503.36 / $2,503.36 / $2,539.89
| Facility | | $2,503.36 | $2,503.36 | $2,539.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $530.04 / $530.04 / $2,710.28
| Facility | | $530.04 | $530.04 | $2,710.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616.19 / $837.00 / $1,318.80
| Facility | | $616.19 | $837.00 | $1,318.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,248.00 / $9,541.00 / $14,589.00
| Facility | | $2,248.00 | $9,541.00 | $14,589.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,973.05 / $8,957.00 / $16,394.00
| Facility | | $2,973.05 | $8,957.00 | $16,394.00 |