- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $412.28 / $903.00 / $7,362.00
| Facility | | $412.28 | $903.00 | $7,362.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,326.31 / $1,326.31 / $1,345.66
| Facility | | $1,326.31 | $1,326.31 | $1,345.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $395.75 / $395.75 / $2,710.28
| Facility | | $395.75 | $395.75 | $2,710.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $412.28 / $501.12 / $931.75
| Facility | | $412.28 | $501.12 | $931.75 |
- 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
- $1,585.32 / $8,957.00 / $12,000.00
| Facility | | $1,585.32 | $8,957.00 | $12,000.00 |