- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $338.31 / $560.23 / $4,311.00
| Facility | | $338.31 | $560.23 | $4,311.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $338.41 / $2,844.33 / $5,654.79
| Facility | | $338.41 | $2,844.33 | $5,654.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $338.31 / $476.38 / $776.16
| Facility | | $338.31 | $476.38 | $776.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $773.00 / $1,208.00 / $9,324.00
| Facility | | $773.00 | $1,208.00 | $9,324.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,390.82 / $2,390.82 / $12,000.00
| Facility | | $2,390.82 | $2,390.82 | $12,000.00 |