- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $653.91 / $1,181.00 / $7,439.00
| Facility | | $653.91 | $1,181.00 | $7,439.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $530.04 / $530.04 / $2,710.28
| Facility | | $530.04 | $530.04 | $2,710.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $653.91 / $828.43 / $1,321.07
| Facility | | $653.91 | $828.43 | $1,321.07 |
- 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
- $2,451.08 / $8,957.00 / $16,394.00
| Facility | | $2,451.08 | $8,957.00 | $16,394.00 |