- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $375.79 / $4,375.00 / $16,467.00
| Facility | | $375.79 | $4,375.00 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,871.55 / $4,006.27 / $6,738.82
| Facility | | $1,871.55 | $4,006.27 | $6,738.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $375.00 / $377.19 / $1,370.63
| Facility | | $375.00 | $377.19 | $1,370.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $351.66 / $436.00 / $706.72
| Facility | | $351.66 | $436.00 | $706.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $729.00 / $6,607.00 / $8,667.00
| Facility | | $729.00 | $6,607.00 | $8,667.00 |