- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $337.42 / $3,396.00 / $10,953.05
| Facility | | $337.42 | $3,396.00 | $10,953.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,754.00 / $6,653.00 / $11,752.00
| Facility | | $2,754.00 | $6,653.00 | $11,752.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $341.00 / $468.03 / $702.05
| Facility | | $341.00 | $468.03 | $702.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,239.56 / $1,239.56 / $1,469.38
| Facility | | $1,239.56 | $1,239.56 | $1,469.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,364.00 / $6,032.00 / $10,413.00
| Facility | | $3,364.00 | $6,032.00 | $10,413.00 |