- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $694.64 / $1,181.00 / $7,439.00
| Facility | | $694.64 | $1,181.00 | $7,439.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $530.04 / $530.04 / $1,215.60
| Facility | | $530.04 | $530.04 | $1,215.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $694.64 / $895.34 / $1,385.42
| Facility | | $694.64 | $895.34 | $1,385.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $554.00 / $2,417.00 / $4,102.00
| Facility | | $554.00 | $2,417.00 | $4,102.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,977.58 / $4,883.64 / $16,394.00
| Facility | | $3,977.58 | $4,883.64 | $16,394.00 |