- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $331.02 / $1,245.00 / $10,453.00
| Facility | | $331.02 | $1,245.00 | $10,453.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $748.70 / $748.70 / $2,710.28
| Facility | | $748.70 | $748.70 | $2,710.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $331.02 / $382.68 / $748.11
| Facility | | $331.02 | $382.68 | $748.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,064.00 / $3,456.00 / $6,388.00
| Facility | | $1,064.00 | $3,456.00 | $6,388.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,291.11 / $8,957.00 / $26,542.00
| Facility | | $1,291.11 | $8,957.00 | $26,542.00 |