- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.05 / $1,181.00 / $7,439.00
| Facility | | $501.05 | $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
- $501.05 / $651.37 / $970.48
| Facility | | $501.05 | $651.37 | $970.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,248.00 / $9,541.00 / $14,589.00
| Facility | | $2,248.00 | $9,541.00 | $14,589.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,355.94 / $8,957.00 / $16,394.00
| Facility | | $3,355.94 | $8,957.00 | $16,394.00 |