- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $683.52 / $1,250.44 / $7,439.00
| Facility | | $683.52 | $1,250.44 | $7,439.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $606.10 / $606.10 / $8,642.16
| Facility | | $606.10 | $606.10 | $8,642.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $683.52 / $936.28 / $1,573.09
| Facility | | $683.52 | $936.28 | $1,573.09 |
- 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
- $3,306.24 / $3,623.11 / $26,542.00
| Facility | | $3,306.24 | $3,623.11 | $26,542.00 |