- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $444.42 / $1,386.00 / $11,093.00
| Facility | | $444.42 | $1,386.00 | $11,093.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,309.00 / $6,474.00 / $13,810.27
| Facility | | $3,309.00 | $6,474.00 | $13,810.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $442.37 / $563.80 / $650.54
| Facility | | $442.37 | $563.80 | $650.54 |
- 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
- $3,364.00 / $6,094.00 / $10,413.00
| Facility | | $3,364.00 | $6,094.00 | $10,413.00 |