- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $566.15 / $938.62 / $7,439.00
| Facility | | $566.15 | $938.62 | $7,439.00 |
- 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
- $566.15 / $705.21 / $1,129.31
| Facility | | $566.15 | $705.21 | $1,129.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,661.00 / $7,659.00 / $10,502.00
| Facility | | $1,661.00 | $7,659.00 | $10,502.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,410.70 / $5,246.20 / $16,394.00
| Facility | | $3,410.70 | $5,246.20 | $16,394.00 |