- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $507.19 / $2,318.00 / $11,093.00
| Facility | | $507.19 | $2,318.00 | $11,093.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,318.00 / $6,474.00 / $13,758.00
| Facility | | $2,318.00 | $6,474.00 | $13,758.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $500.02 / $650.03 / $750.03
| Facility | | $500.02 | $650.03 | $750.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,283.47 / $6,283.47 / $7,448.43
| Facility | | $6,283.47 | $6,283.47 | $7,448.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,472.00 / $10,113.00 / $15,750.00
| Facility | | $4,472.00 | $10,113.00 | $15,750.00 |