- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $569.37 / $2,562.00 / $3,884.00
| Facility | | $569.37 | $2,562.00 | $3,884.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,850.31 / $5,047.10 / $7,809.38
| Facility | | $1,850.31 | $5,047.10 | $7,809.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40.00 / $363.88 / $363.88
| Facility | | $40.00 | $363.88 | $363.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $475.18 / $525.00 / $1,100.00
| Facility | | $475.18 | $525.00 | $1,100.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $689.00 / $2,415.00 / $6,661.00
| Facility | | $689.00 | $2,415.00 | $6,661.00 |