- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $397.92 / $903.00 / $7,362.00
| Facility | | $397.92 | $903.00 | $7,362.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $395.75 / $395.75 / $2,062.80
| Facility | | $395.75 | $395.75 | $2,062.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $397.92 / $511.21 / $783.39
| Facility | | $397.92 | $511.21 | $783.39 |
- 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
- $1,945.05 / $6,817.20 / $12,000.00
| Facility | | $1,945.05 | $6,817.20 | $12,000.00 |