- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,965.00 / $3,758.00 / $7,467.00
| Facility | | $1,965.00 | $3,758.00 | $7,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $672.35 / $2,613.46 / $4,140.09
| Facility | | $672.35 | $2,613.46 | $4,140.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $600.00 / $600.00 / $697.00
| Facility | | $600.00 | $600.00 | $697.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $732.33 / $1,825.61 / $5,692.40
| Facility | | $732.33 | $1,825.61 | $5,692.40 |
- 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 |