- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $787.00 / $1,200.18 / $9,311.00
| Facility | | $787.00 | $1,200.18 | $9,311.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,212.00 / $9,015.00 / $11,253.00
| Facility | | $7,212.00 | $9,015.00 | $11,253.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,112.89 / $1,527.50 / $1,762.08
| Facility | | $1,112.89 | $1,527.50 | $1,762.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,348.10 / $1,348.10 / $1,348.10
| Facility | | $1,348.10 | $1,348.10 | $1,348.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $973.00 / $4,639.00 / $12,296.00
| Facility | | $973.00 | $4,639.00 | $12,296.00 |