- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $637.00 / $1,160.29 / $8,229.00
| Facility | | $637.00 | $1,160.29 | $8,229.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,153.00 / $10,649.70 / $29,900.38
| Facility | | $6,153.00 | $10,649.70 | $29,900.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,080.57 / $1,476.73 / $1,703.52
| Facility | | $1,080.57 | $1,476.73 | $1,703.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,295.02 / $1,295.02 / $1,333.13
| Facility | | $1,295.02 | $1,295.02 | $1,333.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $599.00 / $4,298.00 / $30,001.00
| Facility | | $599.00 | $4,298.00 | $30,001.00 |