- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $210.64 / $527.92 / $5,449.00
| Facility | | $210.64 | $527.92 | $5,449.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,585.61 / $1,585.61 / $1,608.75
| Facility | | $1,585.61 | $1,585.61 | $1,608.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $395.75 / $395.75 / $2,062.80
| Facility | | $395.75 | $395.75 | $2,062.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $210.64 / $401.69 / $604.32
| Facility | | $210.64 | $401.69 | $604.32 |
- 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
- $995.80 / $1,094.02 / $12,000.00
| Facility | | $995.80 | $1,094.02 | $12,000.00 |