- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $368.49 / $1,386.00 / $11,093.00
| Facility | | $368.49 | $1,386.00 | $11,093.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,754.00 / $5,948.00 / $9,462.00
| Facility | | $2,754.00 | $5,948.00 | $9,462.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $345.68 / $440.57 / $508.35
| Facility | | $345.68 | $440.57 | $508.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,982.66 / $2,982.66 / $2,982.66
| Facility | | $2,982.66 | $2,982.66 | $2,982.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,148.00 / $6,094.00 / $12,090.00
| Facility | | $2,148.00 | $6,094.00 | $12,090.00 |