- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $580.00 / $1,520.00 / $3,884.00
| Facility | | $580.00 | $1,520.00 | $3,884.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,753.58 / $4,539.27 / $6,981.81
| Facility | | $1,753.58 | $4,539.27 | $6,981.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40.00 / $477.69 / $1,345.41
| Facility | | $40.00 | $477.69 | $1,345.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $553.14 / $650.00 / $1,936.96
| Facility | | $553.14 | $650.00 | $1,936.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $470.00 / $1,429.00 / $4,010.00
| Facility | | $470.00 | $1,429.00 | $4,010.00 |