- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $302.06 / $459.96 / $5,634.00
| Facility | | $302.06 | $459.96 | $5,634.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,682.00 / $3,950.00 / $13,810.27
| Facility | | $1,682.00 | $3,950.00 | $13,810.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.69 / $450.23 / $662.09
| Facility | | $323.69 | $450.23 | $662.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,218.40 / $2,218.40 / $2,218.40
| Facility | | $2,218.40 | $2,218.40 | $2,218.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,400.00 / $3,870.00 / $5,490.00
| Facility | | $2,400.00 | $3,870.00 | $5,490.00 |