- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $398.03 / $1,995.00 / $7,278.00
| Facility | | $398.03 | $1,995.00 | $7,278.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $530.04 / $530.04 / $1,587.44
| Facility | | $530.04 | $530.04 | $1,587.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $398.03 / $544.42 / $899.55
| Facility | | $398.03 | $544.42 | $899.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,711.00 / $6,331.00 / $9,616.00
| Facility | | $1,711.00 | $6,331.00 | $9,616.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,541.16 / $5,246.20 / $16,394.00
| Facility | | $1,541.16 | $5,246.20 | $16,394.00 |