- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,807.00 / $4,747.00 / $10,439.00
| Facility | | $1,807.00 | $4,747.00 | $10,439.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,686.32 / $1,686.32 / $1,686.32
| Facility | | $1,686.32 | $1,686.32 | $1,686.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $914.00 / $1,700.00 / $1,700.00
| Facility | | $914.00 | $1,700.00 | $1,700.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $841.65 / $1,168.58 / $3,179.37
| Facility | | $841.65 | $1,168.58 | $3,179.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,779.00 / $2,450.00 / $6,307.00
| Facility | | $1,779.00 | $2,450.00 | $6,307.00 |