- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $561.34 / $888.78 / $10,561.00
| Facility | | $561.34 | $888.78 | $10,561.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $748.70 / $748.70 / $2,710.28
| Facility | | $748.70 | $748.70 | $2,710.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $561.34 / $673.61 / $1,063.21
| Facility | | $561.34 | $673.61 | $1,063.21 |
- 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
- $2,177.80 / $8,957.00 / $26,542.00
| Facility | | $2,177.80 | $8,957.00 | $26,542.00 |