- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $802.37 / $3,281.00 / $8,400.00
| Facility | | $802.37 | $3,281.00 | $8,400.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,442.39 / $3,063.20 / $3,867.29
| Facility | | $1,442.39 | $3,063.20 | $3,867.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $800.00 / $2,375.00 / $8,757.00
| Facility | | $800.00 | $2,375.00 | $8,757.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $375.32 / $672.79 / $4,423.00
| Facility | | $375.32 | $672.79 | $4,423.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,037.00 / $3,096.00 / $5,562.00
| Facility | | $1,037.00 | $3,096.00 | $5,562.00 |