- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $361.09 / $818.06 / $7,278.00
| Facility | | $361.09 | $818.06 | $7,278.00 |
- 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
- $361.09 / $610.47 / $912.81
| Facility | | $361.09 | $610.47 | $912.81 |
- 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
- $1,679.60 / $1,855.30 / $16,394.00
| Facility | | $1,679.60 | $1,855.30 | $16,394.00 |