- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $403.72 / $869.40 / $7,278.00
| Facility | | $403.72 | $869.40 | $7,278.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $530.04 / $530.04 / $2,062.80
| Facility | | $530.04 | $530.04 | $2,062.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $403.72 / $676.56 / $1,026.77
| Facility | | $403.72 | $676.56 | $1,026.77 |
- 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
- $1,910.40 / $2,107.42 / $16,394.00
| Facility | | $1,910.40 | $2,107.42 | $16,394.00 |