- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $502.95 / $1,199.91 / $9,727.00
| Facility | | $502.95 | $1,199.91 | $9,727.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $589.00 / $1,723.23 / $3,019.58
| Facility | | $589.00 | $1,723.23 | $3,019.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $375.00 / $574.02 / $1,838.22
| Facility | | $375.00 | $574.02 | $1,838.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $344.77 / $493.43 / $823.61
| Facility | | $344.77 | $493.43 | $823.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $586.00 / $6,172.00 / $8,667.00
| Facility | | $586.00 | $6,172.00 | $8,667.00 |