- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $343.27 / $570.25 / $7,278.00
| Facility | | $343.27 | $570.25 | $7,278.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,311.30 / $1,311.30 / $1,330.43
| Facility | | $1,311.30 | $1,311.30 | $1,330.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $530.04 / $530.04 / $1,215.60
| Facility | | $530.04 | $530.04 | $1,215.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $343.27 / $415.00 / $775.79
| Facility | | $343.27 | $415.00 | $775.79 |
- 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
- $1,331.84 / $4,017.35 / $16,394.00
| Facility | | $1,331.84 | $4,017.35 | $16,394.00 |