- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $791.32 / $3,232.00 / $10,439.00
| Facility | | $791.32 | $3,232.00 | $10,439.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $984.20 / $1,450.76 / $2,689.23
| Facility | | $984.20 | $1,450.76 | $2,689.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $330.00 / $330.00 / $330.00
| Facility | | $330.00 | $330.00 | $330.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $590.61 / $857.46 / $2,608.00
| Facility | | $590.61 | $857.46 | $2,608.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,031.00 / $2,441.82 / $3,331.00
| Facility | | $1,031.00 | $2,441.82 | $3,331.00 |