- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $499.37 / $1,181.00 / $7,439.00
| Facility | | $499.37 | $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
- $499.37 / $656.26 / $1,003.68
| Facility | | $499.37 | $656.26 | $1,003.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,661.00 / $7,659.00 / $10,502.00
| Facility | | $1,661.00 | $7,659.00 | $10,502.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,942.76 / $8,957.00 / $16,394.00
| Facility | | $1,942.76 | $8,957.00 | $16,394.00 |