- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $593.00 / $1,520.00 / $3,685.00
| Facility | | $593.00 | $1,520.00 | $3,685.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,158.02 / $5,970.03 / $10,466.95
| Facility | | $3,158.02 | $5,970.03 | $10,466.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40.00 / $711.49 / $2,807.66
| Facility | | $40.00 | $711.49 | $2,807.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $615.00 / $720.00 / $4,042.13
| Facility | | $615.00 | $720.00 | $4,042.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $746.00 / $2,415.00 / $6,661.00
| Facility | | $746.00 | $2,415.00 | $6,661.00 |