- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $971.00 / $1,678.00 / $3,064.00
| Facility | | $971.00 | $1,678.00 | $3,064.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.85 / $343.06 / $350.00
| Facility | | $323.85 | $343.06 | $350.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $315.00 / $925.00 / $4,707.00
| Facility | | $315.00 | $925.00 | $4,707.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $711.00 / $1,121.00 / $2,409.00
| Facility | | $711.00 | $1,121.00 | $2,409.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,300.00 / $1,454.00 / $2,627.00
| Facility | | $1,300.00 | $1,454.00 | $2,627.00 |