- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $860.00 / $1,595.54 / $8,229.00
| Facility | | $860.00 | $1,595.54 | $8,229.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,755.00 / $8,584.00 / $11,253.00
| Facility | | $4,755.00 | $8,584.00 | $11,253.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,479.50 / $2,030.69 / $2,342.55
| Facility | | $1,479.50 | $2,030.69 | $2,342.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,782.18 / $1,782.18 / $2,128.67
| Facility | | $1,782.18 | $1,782.18 | $2,128.67 |
- 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 |