- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $540.37 / $901.00 / $7,439.00
| Facility | | $540.37 | $901.00 | $7,439.00 |
- 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
- $530.04 / $530.04 / $1,438.74
| Facility | | $530.04 | $530.04 | $1,438.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $540.37 / $641.41 / $1,152.00
| Facility | | $540.37 | $641.41 | $1,152.00 |
- 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
- $2,093.56 / $4,754.80 / $16,394.00
| Facility | | $2,093.56 | $4,754.80 | $16,394.00 |