- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $666.00 / $1,524.00 / $3,728.00
| Facility | | $666.00 | $1,524.00 | $3,728.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,149.07 / $5,237.58 / $7,756.34
| Facility | | $3,149.07 | $5,237.58 | $7,756.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $704.62 / $704.62 / $704.62
| Facility | | $704.62 | $704.62 | $704.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $488.00 / $675.00 / $1,100.00
| Facility | | $488.00 | $675.00 | $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 |