- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $327.18 / $578.38 / $5,634.00
| Facility | | $327.18 | $578.38 | $5,634.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,682.00 / $3,840.00 / $7,747.00
| Facility | | $1,682.00 | $3,840.00 | $7,747.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $307.39 / $391.78 / $550.27
| Facility | | $307.39 | $391.78 | $550.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,868.80 / $1,868.80 / $1,868.80
| Facility | | $1,868.80 | $1,868.80 | $1,868.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,364.00 / $6,094.00 / $10,413.00
| Facility | | $3,364.00 | $6,094.00 | $10,413.00 |