- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $880.00 / $3,219.00 / $10,893.00
| Facility | | $880.00 | $3,219.00 | $10,893.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,065.02 / $1,065.02 / $1,087.88
| Facility | | $1,065.02 | $1,065.02 | $1,087.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,966.02 / $26,542.00 / $26,542.00
| Facility | | $7,966.02 | $26,542.00 | $26,542.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,011.69 / $1,282.08 / $1,774.91
| Facility | | $1,011.69 | $1,282.08 | $1,774.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,033.98 / $1,283.32 / $1,844.25
| Facility | | $1,033.98 | $1,283.32 | $1,844.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $597.00 / $2,064.00 / $4,554.00
| Facility | | $597.00 | $2,064.00 | $4,554.00 |