- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $344.94 / $901.00 / $7,278.00
| Facility | | $344.94 | $901.00 | $7,278.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,703.55 / $1,703.55 / $1,728.40
| Facility | | $1,703.55 | $1,703.55 | $1,728.40 |
- 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
- $344.94 / $642.84 / $987.27
| Facility | | $344.94 | $642.84 | $987.27 |
- 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
- $1,576.52 / $1,746.72 / $16,394.00
| Facility | | $1,576.52 | $1,746.72 | $16,394.00 |