- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,582.00 / $2,933.00 / $6,483.00
| Facility | | $1,582.00 | $2,933.00 | $6,483.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $587.35 / $2,283.06 / $3,616.69
| Facility | | $587.35 | $2,283.06 | $3,616.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $250.00 / $250.00 / $607.00
| Facility | | $250.00 | $250.00 | $607.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $132.46 / $298.01 / $3,911.00
| Facility | | $132.46 | $298.01 | $3,911.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,286.00 / $3,339.00 / $5,838.00
| Facility | | $2,286.00 | $3,339.00 | $5,838.00 |