- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,511.00 / $4,470.00 / $10,439.00
| Facility | | $1,511.00 | $4,470.00 | $10,439.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,433.37 / $1,644.16 / $1,686.32
| Facility | | $1,433.37 | $1,644.16 | $1,686.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $800.00 / $1,630.00 / $1,630.00
| Facility | | $800.00 | $1,630.00 | $1,630.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $517.29 / $736.66 / $3,214.38
| Facility | | $517.29 | $736.66 | $3,214.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $825.00 / $2,063.86 / $3,842.00
| Facility | | $825.00 | $2,063.86 | $3,842.00 |