- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $518.24 / $1,386.00 / $14,063.00
| Facility | | $518.24 | $1,386.00 | $14,063.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,754.00 / $6,818.00 / $11,598.00
| Facility | | $2,754.00 | $6,818.00 | $11,598.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $482.22 / $626.89 / $723.33
| Facility | | $482.22 | $626.89 | $723.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $604.55 / $761.00 / $1,873.52
| Facility | | $604.55 | $761.00 | $1,873.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,500.00 / $5,995.00 / $9,243.00
| Facility | | $1,500.00 | $5,995.00 | $9,243.00 |