- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $447.35 / $2,439.04 / $6,446.00
| Facility | | $447.35 | $2,439.04 | $6,446.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,678.00 / $3,485.00 / $5,737.00
| Facility | | $1,678.00 | $3,485.00 | $5,737.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $455.00 / $1,754.69 / $3,125.00
| Facility | | $455.00 | $1,754.69 | $3,125.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,300.68 / $7,909.30 / $26,542.00
| Facility | | $1,300.68 | $7,909.30 | $26,542.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $3,351.00 / $6,285.00
| Facility | | $1,000.00 | $3,351.00 | $6,285.00 |