- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $767.00 / $1,435.00 / $3,804.00
| Facility | | $767.00 | $1,435.00 | $3,804.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,727.30 / $6,727.30 / $8,072.76
| Facility | | $6,727.30 | $6,727.30 | $8,072.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $831.55 / $905.52 / $2,537.08
| Facility | | $831.55 | $905.52 | $2,537.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,588.14 / $4,588.14 / $4,588.14
| Facility | | $4,588.14 | $4,588.14 | $4,588.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,104.00 / $4,055.91 / $8,676.00
| Facility | | $2,104.00 | $4,055.91 | $8,676.00 |