- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $243.31 / $1,728.50 / $13,335.00
| Facility | | $243.31 | $1,728.50 | $13,335.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $589.00 / $3,803.96 / $7,785.29
| Facility | | $589.00 | $3,803.96 | $7,785.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $375.00 / $615.00 / $933.68
| Facility | | $375.00 | $615.00 | $933.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $243.31 / $878.58 / $1,278.81
| Facility | | $243.31 | $878.58 | $1,278.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $586.00 / $6,172.00 / $8,667.00
| Facility | | $586.00 | $6,172.00 | $8,667.00 |