- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $669.89 / $973.86 / $7,439.00
| Facility | | $669.89 | $973.86 | $7,439.00 |
- 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
- $669.89 / $836.38 / $1,327.39
| Facility | | $669.89 | $836.38 | $1,327.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,711.00 / $7,162.00 / $10,397.00
| Facility | | $1,711.00 | $7,162.00 | $10,397.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,446.33 / $8,957.00 / $12,000.00
| Facility | | $4,446.33 | $8,957.00 | $12,000.00 |