- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $787.00 / $1,520.33 / $9,311.00
| Facility | | $787.00 | $1,520.33 | $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
- $1,063.68 / $1,459.95 / $1,684.16
| Facility | | $1,063.68 | $1,459.95 | $1,684.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,284.40 / $1,284.40 / $1,284.40
| Facility | | $1,284.40 | $1,284.40 | $1,284.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $973.00 / $4,639.00 / $15,075.00
| Facility | | $973.00 | $4,639.00 | $15,075.00 |