- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $657.19 / $4,311.00 / $11,205.76
| Facility | | $657.19 | $4,311.00 | $11,205.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $395.75 / $395.75 / $2,710.28
| Facility | | $395.75 | $395.75 | $2,710.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $657.19 / $826.31 / $1,362.35
| Facility | | $657.19 | $826.31 | $1,362.35 |
- 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
- $2,443.67 / $8,957.00 / $12,000.00
| Facility | | $2,443.67 | $8,957.00 | $12,000.00 |