- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $339.32 / $815.44 / $8,413.00
| Facility | | $339.32 | $815.44 | $8,413.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $606.10 / $606.10 / $6,025.59
| Facility | | $606.10 | $606.10 | $6,025.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $339.32 / $596.29 / $872.88
| Facility | | $339.32 | $596.29 | $872.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,206.00 / $6,575.00 / $9,616.00
| Facility | | $2,206.00 | $6,575.00 | $9,616.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,608.92 / $1,771.80 / $26,542.00
| Facility | | $1,608.92 | $1,771.80 | $26,542.00 |