- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $657.62 / $3,569.00 / $10,439.00
| Facility | | $657.62 | $3,569.00 | $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
- $442.00 / $442.00 / $442.00
| Facility | | $442.00 | $442.00 | $442.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $387.33 / $667.79 / $3,561.00
| Facility | | $387.33 | $667.79 | $3,561.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,436.00 / $3,096.00 / $5,565.00
| Facility | | $1,436.00 | $3,096.00 | $5,565.00 |